News and Bulletins Archive

On December 5, 2014, Hilltop, together with the UMBC Department of Public Policy, the Maryland Institute for Policy Analysis and Research, CareFirst, and LifeBridge Health, sponsored a public policy forum describing how hospitals and health care providers in Maryland are adapting to the new all-payer model, and the likely effect on the populations that hospitals serve. Click here for the program and presentations.

Posted 12/8/14

Hilltop Presents to National Association of State Head Injury Administrators

Hilltop Senior Policy Analyst Stephanie Cannon-Jones, MPP, gave a presentation at the 25th Annual State of the States in Head Injury Conference on October 28, 2014 in Philadelphia, PA. Cannon-Jones’ presentation, Medicaid Expenditures for Persons with Brain Injury while Residing in a Nursing Facility, described the key findings of a study that examined Medicaid expenditures and service utilization patterns of Maryland Medicaid-eligible beneficiaries with a brain injury diagnosis who resided in nursing facilities.

Posted 11/5/14

Bulletin: Hilltop Celebrates 20 Years of Service at Special Event

On October 23, 2014, Hilltop held a special event to celebrate its 20th anniversary. Over the years, Hilltop has grown to become one of the most highly regarded university-based health policy research organizations in the country. The event featured Bruce Vladeck, PhD, as the keynote speaker.

Hilltop Hospital Community Benefit Program Presents at 2014 NASHP Conference

Hilltop Hospital Community Benefit Program Director Gayle Nelson gave a presentation at the National Academy for State Health Policy’s 27th Annual State Health Policy Conference on October 8, 2014, in Atlanta, Georgia. In her presentation, titled Leveraging Hospital Community Benefit Requirements, Nelson discussed hospital community benefits and various approaches states could use to leverage them to improve population health.

Posted 10/16/14

Hilltop Presents at National HCBS Conference

Hilltop Director of Special Studies Ian Stockwell, PhD, gave a presentation at the National Association of States United for Aging and Disabilities’ National Home & Community Based Services Conference in Arlington, Virginia, on September 18, 2014. In the presentation, titled The Use of Clinical and Functional Assessment Instruments, Stockwell discussed selection and use of assessment tools—which can have a broad effect across program and policy areas—and how this selection and use can help realize the potential to pull individual-level information together to form a complete picture of a program population.

Posted 9/22/14

Hilltop Presents to Milbank’s Reforming States Group Steering Committee

Hilltop Hospital Community Benefit Program Director Gayle D. Nelson, JD, MPH, gave a presentation to the steering committee of the Milbank Memorial Fund-supported Reforming States Group (RSG) at their meeting in Chicago, Illinois, on August 27, 2014. In her presentation, titled Hospital Community Benefit: A Policy Lever for States, Nelson discussed hospital community benefit and the cost of tax exemption; using hospital community benefit as a policy lever; and avenues interested policymakers could explore with respect to their own states’ community benefit landscapes. The RSG is a bipartisan group of state health policy leaders from both the Executive and Legislative branches who, with a small group of international colleagues, have been gathering since 1992 to share information, develop professional networks, and commission joint projects–all in the service of bringing evidence to bear to improve population health.

Posted 9/10/14

Bulletin: Hilltop Receives Kresge Foundation Grant
to Continue Support for Hospital Community Benefit Program

The Hilltop Institute’s Hospital Community Benefit Program has received a two-year grant from the Kresge Foundation to continue to provide timely information on emerging trends and important issues related to community benefit.

Hilltop Presents at ASTHO Webinar on Community Health Needs Assessment and Health Equity

Hilltop Hospital Community Benefit Program Director Gayle D. Nelson, JD, MPH, was part of a panel that presented at an Association of State and Territorial Health Officers (ASTHO) webinar on June 24, 2014, titled Community Health Needs Assessments [CHNAs]: A Tool for Achieving Health Equity. The webinar was attended by state and territorial health officials, their leadership teams, directors of state offices of health equity/minority health and primary care, and partner organizations. Nelson’s presentation, Advancing Health Equity through the CHNA/Implementation Strategy Process, discussed how public health agencies can utilize the CHNA/implementation strategy process to promote health equity and identified key steps in the process for advancing this goal.

Bulletin: Hilltop Releases Issue Brief on Social and Economic Factors that Shape Health

Hilltop’s Hospital Community Benefit Program has just released the ninth issue brief in its series, Hospital Community Benefits after the ACA. This brief, Addressing Social and Economic Factors that Shape Health, continues the program’s examination of state-level community benefit oversight by focusing on the ten states that require hospitals to develop implementation strategies.

Hilltop Researcher Co-Authors Two Articles Published in Psychiatric Services

Hilltop Senior Research Analyst Michael T. Abrams, MPH, co-authored two articles published in the April 2014 issue of Psychiatric Services. The articles are both based on a study of low-income young adults (aged 18-26) discharged from an inpatient psychiatric event, a marker for serious mental distress. Identifying Young Adults at Risk of Medicaid Enrollment Lapses after Inpatient Mental Health Treatment discusses a study that identified antecedents to Medicaid enrollment lapses in the year following discharge. Such lapses are undesirable because they suggest absence of medical attention that is especially indicated in the wake of an inpatient psychiatric stay. Medicaid Lapses and Low-Income Young Adults' Receipt of Outpatient Mental Health Care after an Inpatient Stay discusses a second study that estimated the impacts of Medicaid enrollment disruptions on access to mental health services in the same year following inpatient discharge. That study found that Medicaid disruptions correlated with reduced outpatient mental health service utilization and lower medication possession ratios. Jointly, these articles offer information to policymakers and others regarding the reasons and the potentially negative health care consequences of insurance discontinuities for young adults with substantial (albeit emerging) mental health needs. Such young adults represent an important subset of persons who should gain broader access to medical care coverage via the Affordable Care Act.

Posted 4/11/14

Hilltop Publishes Work on Propensity Score Matching as Method to Study Medicare Part D

In collaboration with a team that includes researchers at Johns Hopkins and UMBC's Department of Public Policy, researchers at The Hilltop Institute have published a new peer-reviewed article in the AcademyHealth journal eGEMs titled Estimating Causal Effects in Observational Studies Using Electronic Health Data: Challenges and (some) Solutions. Researchers used Medicaid and Medicare administrative data to study the impact of the Medicare prescription drug program, Part D (first implemented in 2006), on persons with serious mental illness (SMI). Such a study is important because persons with SMI are medically vulnerable and because a large proportion of their prescription drug health care coverage shifted from state to federal responsibility as a result of the Part D program. The published study describes propensity score methods to "match" persons with Medicare and Medicaid coverage (dual eligibles) to persons with similar demographic and health profiles who are only engaged in Medicaid. Such matching is necessary to balance the selected samples so that they are comparable for inference testing. The suggested citation for this work appears below, and the full article can be viewed here: http://repository.academyhealth.org/egems/vol1/iss3/4. For more information about this work, please contact Hilltop Senior Policy Analyst, Michael Abrams at mabrams@hilltop.umbc.edu.

The Hilltop Institute’s Hospital Community Benefit Program has received a grant from the Robert Wood Johnson Foundation® to continue to provide timely information on emerging trends and important issues related to community benefit. The program will produce three issue briefs as part of its Hospital Community Benefits after the ACA series over an eighteen-month period, the first of which will be published in the spring of 2014.

Hilltop Presents at 2013 APHA Annual Meeting

Hilltop Director of Medicaid Policy Studies David A. Idala, MA, presented a poster at the American Public Health Association 141st Annual Meeting and Exposition held November 2-6, 2013, in Boston, MA. The poster, titled The Use of Emergency Department Services for Non-Emergent Conditions among Adults with Disabilities, displayed the methods and findings of a study of the relationship between emergency department use and disability in adults. View the poster.

Posted 11/07/13

Hilltop Presents at 2013 American Evaluation Association Conference

Hilltop staff made two panel presentations and a poster presentation at Evaluation 2013: The State of Evaluation Practice in the Early 21st Century, the27th Annual Conference of the American Evaluation Association held from October 16-19, 2013, in Washington, DC. Hilltop Senior Policy Analyst Charles Betley, MA, presented a poster titled The Use of Emergency Department Services for Non-Emergent Conditions among Adults with Disabilities, which displayed the methods and findings of an study of the relationship between emergency department use and disability in adults. View the poster. Hilltop Policy Analyst Jessica Skopac, JD, PhD, MA, gave a presentation titled Utilizing "The Guide"
to Strengthen Partnerships
and to Inform Evaluation Planning for
the Maryland Asthma Control Program, in which she discussed the methods and findings of Hilltop’s evaluation of the MACP and how to engage partners more effectively. View the presentation.

Posted 10/23/13

Bulletin: Hilltop Releases Issue Brief on Current and Future Community Benefit Policy

The Hilltop Institute’s Hospital Community Benefit Program has just released the eighth issue brief in its series, Hospital Community Benefits after the ACA. This brief, Present Posture, Future Challenges, focuses on updating significant points concerning community health needs assessment (CHNA) and other aspects of community benefit discussed in earlier briefs in the series, as well as on identifying and exploring more recent developments and emerging issues.

Hilltop Presents at NCSL Fiscal Analysts Seminar

On October 8, 2013, Hilltop Executive Director Cynthia H. Woodcock, MBA, gave a presentation at the National Conference of State Legislatures (NCSL) Fiscal Analysts Seminar. The seminar, held in Annapolis October 6 through October 9, was attended by fiscal staff from across the country. In her presentation titled Integrating and Coordinating Care for Dually Eligible Individuals, Woodcock discussed the characteristics of Medicare-Medicaid enrollees (dual eligibles); pathways to dual eligibility; opportunities for and challenges of integrating care for this population; approaches to integrating care; and what questions to ask about program design, financing, managed care organizations, data and IT, quality monitoring, stakeholders, program roll-out, and resources.

Bulletin: Gayle Nelson to Lead Hilltop’s Hospital Community Benefit Program

The Hilltop Institute is pleased to announce that Gayle D. Nelson, JD, MPH, is the new director of its Hospital Community Benefit Program. Nelson is a senior policy analyst at The Hilltop Institute and has been with the program since she joined Hilltop in 2012. She is co-author of the program’s issue briefs and led the development and implementation of Hilltop’s online resource, the Community Benefit State Law Profiles, a compilation of each state’s community benefit laws and regulations, analyzed in the context of the Affordable Care Act’s (ACA’s) community benefit framework.

Bulletin: Hilltop Releases Second Issue Brief Related to Community Benefit State Law Profiles

The Hilltop Institute’s Hospital Community Benefit Program has just released a second issue brief related to its online resource, theCommunity Benefit State Law Profiles.This brief, Hospital Community Benefits after the ACA: Policy Implications of the State Law Landscape, describes state community benefit requirements organized into eight categories that largely reflect either pre-existing federal community benefit standards or additional requirements set forth in §9007 of the Affordable Care Act (ACA). It also compares and contrasts various states and discusses the policy implications of the findings.

Hilltop to Partner on Asthma Study

The U.S. Department of Housing and Urban Development has awarded a three-year, $750,000 grant to UMBC’s Hilltop Institute and Maryland Institute for Policy Analysis and Research (MIPAR), as well as the Green and Healthy Homes Initiative™(GHHI), to conduct a cost benefit analysis of the reduction in asthma and associated Medicaid expenditures resulting from the implementation of GHHI’s interventions. GHHI is a national program spearheaded by the Coalition to End Childhood Lead Poisoning with the aim of integrating health-based housing interventions with weatherization to create access to healthy homes for children in low-income neighborhoods. The UMBC study will focus on GHHI interventions in the homes of low-income families with asthma-diagnosed children in Baltimore City. The project will evaluate the extent to which GHHI interventions affect asthma morbidity and health care utilization costs, school absences, utility costs, and work-loss days for parents or caregivers of children with asthma. The study will also examine how different levels of GHHI interventions affect post-intervention resident health and overall non-medical and energy cost savings. The interdisciplinary research team includes Principal Investigator David Salkever of the UMBC Department of Public Policy/MIPAR, Co-Investigator Michael Abrams of The Hilltop Institute, researchers from the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health, and Co-Principal Investigator Ruth Ann Norton, Executive Director of the Coalition to End Childhood Lead Poisoning/GHHI.

The Hilltop Institute has just released the latest in a series of summariesof federal guidance issued pursuant to the Affordable Care Act (ACA). Overview of the Final Rule on Medicaid, CHIP, and Exchanges provides a detailed yet concise summary of the rule issued by the U.S. Department of Health and Human Services on July 5, 2013, and highlights key changes to the regulation since the issuance of the proposed rule in January 2013.

Community Benefit State Law Profiles Featured on CDC's Website

Community Benefit State Law Profiles, the interactive online tool developed by Hilltop’s Hospital Community Benefit Program, are featured in the Centers for Disease Control and Prevention’s (CDC’s) July 2013 edition of Public Health Law News. In this article, the CDC links to the Profiles, which "present a comprehensive analysis of each state's community benefit landscape as defined by its laws, regulations, tax exemptions, and, in some cases, policies and activities of state executive agencies."

Hilltop Presents Poster at NACCHO Annual 2013

Hilltop Hospital Community Benefit Program Director Martha Somerville, JD, MPH, and Policy Analyst Gayle Nelson, JD, MPH, presented a poster at the National Association of County and City Health Officials (NACCHO) annual conference held July 10-12, 2013, in Dallas, Texas. The poster, Community Benefit State Law Profiles, highlights the variation in community benefit laws across states in comparison with the federal community benefit standard and showcases the program’s online tool, where users can compare these requirements across states. View the poster.

Posted 07/11/13

Community Benefit State Law Profiles Comparison Tool Featured in the Kresge Foundation's News

Community Benefit State Law Profiles, the interactive online tool developed by Hilltop’s Hospital Community Benefit Program, is featured in the Kresge Foundation’s latest news. In this article, Hospital Community Benefit Program Director Martha H. Somerville, JD, MPH, explains that there is “tremendous variation” among states’ community benefit requirements and that this tool can “help policymakers assess where their states stand now and determine where they want to go.”

Hilltop Presents at AcademyHealth Annual Research Meeting

Three Hilltop staff presented at the AcademyHealth Annual Research Meeting on June 23, 2013, in Baltimore, Maryland. Hospital Community Benefit Program Director Martha H. Somerville, JD, MPH, and Policy Analyst Gayle Nelson, JD, MPH, gave a poster presentation entitled Community Benefit State Law Profiles, which highlights the variation in community benefit laws across states in comparison with the federal community benefit standard. View the poster. Somerville also delivered a panel discussion, Community Health Needs Assessment: Legal Requirements, Practical Opportunities, on June 25. This presentation discusses hospital charity care/community benefits/tax exemption; federal community health needs assessment and implementation strategies; collaborative needs assessment; and the role of nonprofit hospitals in health system transformation. View the presentation. On June 24, Hilltop Senior Research Analyst Michael Abrams, MPH, gave a podium presentation, Impact of Coordination/Integration on Medicaid Expenditures for Persons with Substance Use Disorders, at which he discussed his findings that cost savings of approximately $1,000 per member per year are correlated with coordination of care efforts targeting persons with substance use disorders. View the presentation. Abrams also presented a poster, Imminent Medicaid Enrollment Lapses after Inpatient Mental Health Treatment in Young Adult, which reveals factors that increase or decrease risk of Medicaid disenrollment among young adults (aged 18-26) discharged from an inpatient psychiatric stay. View the poster.

Posted 07/08/13

Bulletin: Hilltop Launches New Interactive Features in Community Benefit State Law Profiles Comparison Tool

Hilltop’s Hospital Community Benefit Program has added exciting new interactive features to its Community Benefit State Law Profiles.
New enhancements added to the State Comparison Tableenable a user to 1) sort by a selected community benefit requirement, 2) access state-specific details about a selected legal requirement, and 3) compare the community benefit requirements of multiple states.

Hilltop Presents at NaCo Webinar on Community Health Needs Assessment

Hilltop Hospital Community Benefit Program Policy Analyst Gayle D. Nelson, JD, MPH, gave a presentation at a National Association of Counties (NaCo) webinar titled Using the Community Health Needs Assessment to Inform Policymaking on May 30, 2013. In her presentation, Community Health Needs Assessment: A Tool for Improving Community Health, Nelson provided a legal context for community health needs assessment (CHNA); described CHNA’s role in community health improvement; and discussed CHNA requirements and processes for nonprofit hospitals. View the presentation.

Hilltop is the host and a co-sponsor of the AcademyHealth 2013 Delivery System Transformation Meeting, an adjunct meeting of the AcademyHealth Annual Research Meeting (ARM) to be held in Baltimore this year. The meeting, titled Transforming Health and Health Care – Focus on Maryland, is open to all and will be held on June 21, 2013, from 8:30 am until 6:30 pm at UMBC.

The Delivery System Transformation Meeting provides a unique opportunity to bring together local health care leaders and national health services researchers, policy analysts, and other experts to get to know one another and to discuss issues of mutual interest in payment and delivery system reform and population health. The meeting will showcase Maryland innovations, such as the State Health Improvement Process (SHIP) and Health Enterprise Zones, and will also provide updates from forward-thinking leaders on health information technology, health disparities, information exchange, and safety net redesign.

Hilltop Work on Breast Cancer Screening Presented at International Meeting

Hilltop Senior Research Analyst Michael Abrams, MPH, was co-author on a presentation made recently at an international meeting focused on schizophrenia research (see citation below). The work demonstrates that, among women with serious mental illness who are engaged in Maryland Medicaid, those with substance use disorders are at elevated risk for missing breast cancer screening. By somewhat surprising contrast, women with other mental disorders (e.g., schizophrenia and depression), were not at elevated risk for missing such screening. For more information, contact mabrams@hilltop.umbc.edu.

Hilltop Presents at IOM Health Equity Workshop

Hilltop Hospital Community Benefit Program Director Martha H. Somerville, JD, MPH, gave a presentation at an Institute of Medicine (IOM) workshop titled Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients on April 22, 2013, in Hartford, Connecticut. In her presentation, Driving Health Equity through Public Policy: Hospital Community Benefits, Somerville discussed tax-exempt hospitals’ community benefit responsibilities under the Affordable Care Act (ACA) and identified how the ACA requirements can be used as levers to advance health equity. View the presentation.

Posted 04/29/13

Results of Hilltop’s Evaluation of Kids First Outreach Published by Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation recently published the results of Hilltop’s study to evaluate the outreach efforts of Maryland’s Kids First program in a report titled How Well Did Maryland Identify and Enroll Uninsured Children Who Are Potentially Eligible for Medicaid or CHIP? The report describes Hilltop’s study, the challenges that the Maryland Department of Health and Mental Hygiene faced in its attempts to obtain information from the Comptroller’s office, and how Hilltop’s findings during the course of the project led to changes in Maryland’s tax forms that enabled more targeted mailings and the enactment of new legislation that facilitates data sharing. To learn more about the study, read these three issue briefs:

Hilltop Presents at the 2013 Annual Conference of the American Society on Aging

Hilltop Policy Analyst Aaron Tripp, MSW, gave a presentation at the 2013 Annual Conference of the American Society on Aging in Chicago on March 14, 2013. New Jersey Care Partner Support Pilot Program: Findings—which has been presented before and continues to spark interest—discussed highlights of Hilltop’s evaluation of the Pilot Program, which was designed to improve the knowledge and skills of family caregivers for beneficiaries enrolled in waiver programs following a caregiver self-assessment. Implications for health care and social service professionals to better recognize and support families as partners in care and recommendations for further expansion of caregiver assessments were addressed.

Posted 03/14/13

Bulletin: Hilltop Releases Community Benefit State Law Profiles
and Companion Issue Brief

The Hilltop Institute’s Hospital Community Benefit Program has just released a new online resource, the Community Benefit State Law Profiles.The Profiles are a compilation of each state’s community benefit laws and regulations, analyzed in the context of the ACA’s community benefit framework. A companion issue brief, Hospital Community Benefits after the ACA:The State Law Landscape, presents the Profiles’ findings and begins the analysis—in effect, viewing state community benefit standards through the lens of the ACA—to facilitate a better understanding of each state’s community benefit landscape and its significance in the context of national health reform. Read the bulletin.

Posted 03/11/13

Bulletin: Cynthia Woodcock Returns to Hilltop as Executive Director

UMBC and The Hilltop Institute are pleased to announce that Cynthia H. Woodcock has been named Hilltop’s next executive director. An MBA by training, Ms. Woodcock’s managerial skills span organizational development, strategic planning, marketing and new business development, system design, and financial management. Ms. Woodcock knows Hilltop well; she was a part of the organization in various capacities from 2004 to 2011. Her appointment begins March 4. Read the bulletin.

Posted 02/21/13

Hilltop Research Shows “Coordination of Care Efforts” for Persons with Substance Use Disorders in Maryland May Already Yield Medicaid Savings

On January 31, 2013, Michael Abrams, MPH, Senior Research Analyst at The Hilltop Institute, presented research to the Performance and Evaluation Committee of Baltimore Substance Abuse System, Inc. (bSAS), demonstrating that quantitative Medicaid expenditure savings in CY 2010 for patients with substance use disorders (SUDs) were correlated with the “coordination of care reputation” of those patients’ providers. Though the work relied on an imprecise definition for “care coordination,” it nevertheless yielded highly significant point estimates for per person Medical saving on the order of $1,000 a year. This translates to calculated savings of just over $7 million in the population studied (a 59% sample of Maryland Medicaid enrollees with SUDs), Furthermore, this work was validated by separate correlations, showing that “coordination of care” was also significantly associated with reduced inpatient service use. Abrams led the research team, which included Seung Kim (Policy Analyst, Hilltop), Jayne Miller (Senior Programmer, Hilltop), Jose Arbelaez (Director of Epidemiology and Evaluation, bSAS), and Yngvild Olsen (private consultant and Medical Director for the Institutes of Behavior Resources, Inc.). This work was funded by bSAS. View the presentation. To learn more about this research, contact Michael Abrams.

Posted 02/04/13

Hilltop Presents Poster at National Summit on Eliminating Health Disparities

Hilltop Director of Medicaid Policy Studies David Idala, MA, and Policy Specialist Yi-An Chen, MA, presented a poster at the 2012 Summit on the Science of Eliminating Health Disparities, on December 18, 2012, in National Harbor, Maryland. The poster, titled The Use of Emergency Department (ED) Services for Non-Emergent Conditions among Adults with Disabilities, displays the preliminary results of a study that explores the impact of race/ethnicity and insurance status on ED use among individuals with disabilities. View the poster.

Posted 12/18/12

Hilltop Presents at NCSL Fall Forum

Hilltop Long-Term Services and Supports Policy and Research Director Donna C. Folkemer, MA, gave a presentation titled Improving Care: State Legislative Role in Improving the Quality of Long-Term Services and Supports at the National Conference of State Legislatures (NCSL) Fall Forum Pre-Conference Meeting on December 5, 2012, in Washington, DC. In her presentation, Folkemer discussed eight things legislators should know about quality. The pre-conference meeting was attended by legislators and legislative staff from across the country. View the presentation.

Posted 12/10/12

Hilltop Moderates Session at Health Insurance Exchange Summit

Hilltop Interim Executive Director Mike Nolin was the moderator of a session titled State Experience in Working on the Health Insurance Exchanges at the Health Insurance Exchange Summit held on November 29 and 30, 2012, in Las Vegas, Nevada. The conference was attended by approximately 150 leaders from around the country. On the panel were a health plan representative from Massachusetts, Utah’s coordinator of health reform, the executive director of the Minnesota Exchange, the assistant commissioner for the New Jersey Department of Banking and Insurance, and director of the Tennessee Insurance Exchange Planning Initiative.

Hilltop made several presentations at the 65th Annual Scientific Meeting of the Gerontological Society of America that took place November 14-18, 2012, in San Diego. On November 14, Hilltop presented a symposium session titled Medicare-Medicaid Enrollees: An Examination of New Maryland Enrollees and Pathways to Coverage. The purpose of the session was to discuss the findings of the research Hilltop conducted to examine the experience of Maryland Medicare-Medicaid enrollees before their eligibility for both programs. The research identified and cataloged significant differences between persons who first enroll in Medicaid and then in Medicare and those who first enroll in Medicare and then in Medicaid. In the session, Hilltop researchers shared the results of their analyses and findings from a background paper about pathways to eligibility for both programs. Hilltop Director of Long-Term Services and Supports Policy and Research Donna Folkemer, MA, moderated the session. Cynthia Woodcock, MBA, formerly of Hilltop and now Practice Area Lead, Long-Term Care, Aging, and Disability at IMPAQ International, discussed the literature review that described the various pathways to eligibility, presented examples of programs aimed at delaying functional decline and/or poverty, and reviewed enrollment barriers faced by individuals who need both Medicare and Medicaid coverage. Hilltop Policy Analyst Aaron Tripp, MSW, discussed the study on demographic and programmatic characteristics, which compared and contrasted enrollees in both programs with particular attention to identifying differences among various groups. Hilltop Director of Special Studies Ian Stockwell, MA, discussed the study on prior Medicare and Medicaid resource use, which examined chronic disease patterns and prior health care expenditures of persons who began to receive coverage in 2008 from both Medicare and Medicaid. Chuck Milligan, JD, MPH, Maryland Department of Health and Mental Hygiene Deputy Secretary of Health Care Financing, was the discussant for the session. View the presentation. View the three study reports.

Hilltop Hosts Colloquium on Implementing Insurance Coverage Expansion

On October 26, 2012, Hilltop held a colloquium, Health Reform: Implementing Insurance Coverage Expansion, for UMBC faculty, staff, and students, where attendees learned about the policy and financial structure of health insurance reform, as well as the status of its implementation nationally and in Maryland. Click here for more information.

Posted 11/1/12

Hilltop Presents at NASHP 25th Annual State Health Policy Conference

Hilltop Senior Policy Analyst Laura Spicer, MA, gave a presentation at the National Academy for State Health Policy (NASHP) 25th Annual State Health Policy Conference held October 15-17, 2012, in Baltimore. In the presentation, Impact of Medicaid Expansion on a State’s Economy: The Hilltop Health Care Reform Simulation Model, Spicer gave an overview of the Hilltop Health Care Reform Simulation Model, a financial modeling tool developed by Hilltop Director of Economic Analysis Hamid Fakraei, PhD, that projects the costs and savings to states as they implement the provisions of the Affordable Care Act (ACA). Spicer discussed the economic impacts of the ACA and how the model was used in Maryland to isolate the impact of Medicaid Expansion and inform the decision by Maryland policymakers to expand Medicaid in 2015. View the presentation. Learn more about the Hilltop Health Care Simulation Model.

Posted 10/18/12

Bulletin: Hilltop Releases Issue Brief on Lessons Learned from the Implementation of the Maryland Kids First Act

Hilltop has just released a new Issue Brief entitled Lessons from the Implementation of the Maryland Kids First Act, which highlights key findings from Hilltop’s study that evaluated the Kids First outreach initiative. The overarching goal of the study was to evaluate the implementation of Kids First and how well the state achieved its goal of identifying and enrolling uninsured children who are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) in order to glean lessons for not only Maryland, but also other states. This brief describes the factors that facilitated Kids First, as well as the key challenges that Maryland faced as it implemented the initiative. Read the brief. View the Bulletin.

Posted 10/16/12

Bulletin: Hilltop Releases Issue Briefs on IRS Form 990 Schedule H and on Community Building

Hilltop Presents at 28th Annual National HCBS Conference

Hilltop Policy Analyst Aaron Tripp, MSW, gave a presentation with IMPAQ International Senior Research Associate Cynthia H. Woodcock, MBA, at the 28th Annual National Home and Community-Based Services (HCBS) Conference in Arlington, VA, which took place September 10 through 13, 2012. This session, entitled Assessing Family Caregiver Needs: The New Frontier, included presentations from the AARP Public Policy Institute and the Family Caregiver Alliance. The presentation, entitled New Jersey Care Partner Support Pilot Program: Findings, discussed highlights of Hilltop’s evaluation of the Pilot Program, which was designed to improve the knowledge and skills of family caregivers for beneficiaries enrolled in waiver programs following a caregiver self-assessment. Implications for health care and social service professionals to better recognize and support families as partners in care and recommendations for further expansion of caregiver assessments were addressed.

Posted 9/14/12

Bulletin: Hilltop Releases Report on Coordination of Care for Persons
with Substance Use Disorders under the Affordable Care Act

Hilltop Senior Research Analyst Michael T. Abrams, MPH, explores the opportunities and challenges pertaining to the enhanced integration/coordination of substance use disorder (SUD) treatments into the publicly financed health care delivery system in a report entitled Coordination of Care for Persons with Substance Use Disorders under the Affordable Care Act: Opportunities and Challenges. Read the report. View the Bulletin. Contact Michael Abrams.

The Hilltop Institute is the co-recipient of a National Institute of Mental Health (NIMH) grant entitled Multiple-Impact Effectiveness of a State-Supported Employment Policy Initiative. The project will study the economic and health impacts of evidence-based supported-employment (SE) strategies for persons in Maryland Medicaid with serious mental illness (SMI). Such strategies were aggressively expanded in the mid- to late 2000s, the time frame of this investigation. The research effort will integrate data from several sources, including Maryland Medicaid and public mental health system claims, in order to evaluate the intensity of SE therapy received, as well as health and employment outcomes that appear to follow from that treatment. David Salkever, PhD, professor in UMBC’s Department of Public Policy, is the principal investigator on this work. Hilltop Senior Research Analyst Michael Abrams, MPH, will lead the Hilltop team for this project, which will also include Senior Programmer Jack Clark.

The Hilltop Institute is pleased to announce the success of its sixth invitational symposium, Information Follows the Person: Advancing LTSS Integrated Electronic Records, which convened on June 14, 2012. To learn more about the speakers, view the presentations, and see the agenda, click here. To view the bulletin, click here.

Posted 7/31/12

Bulletin: Hilltop Health Care Reform Simulation Model Now Available to States

The Hilltop Health Care Reform Simulation Model, a financial modeling tool that projects the costs and savings to states as they implement the provisions of the Affordable Care Act (ACA), is now available to states who want to use it to make these projections. To view the Bulletin about the model, click here.

Posted 7/19/12

Hilltop Presents at American Public Health Association

Hilltop Interim Executive Director Michael A. Nolin, MA, made a presentation at the American Public Health Association’s midyear meeting on June 27, 2012, in Charlotte, North Carolina. The session, titled All in This Together - Public Health and Community Benefit, addressed the requirement for nonprofit hospitals to demonstrate their commitment to community health by conducting a community health needs assessment (CHNA) along with a strategy to address the identified needs to support their nonprofit tax status. In his presentation, Nolin gave an overview of the origins of the community benefit standard and discussed the standard in both a federal and state context; discussed the Internal Revenue Service’s (IRS) reporting requirements for nonprofit hospitals; discussed the CHNA requirements under the Affordable Care Act (ACA); and addressed state policy factors related to CHNAs. Finally, Nolin gave examples of how hospital associations might be responding to these requirements. To view the presentation, click here.

Posted 7/02/12

Hilltop Presents at AcademyHealth Annual Research Meeting

Hilltop Interim Executive Director Michael A. Nolin, MA, was a panelist in a special session at the AcademyHealth Annual Research Meeting on June 24, 2012, in Orlando, Florida. This special session, Building Research Collaborations with State Health Policymakers, used the states of California and Maryland as examples to address the benefits and challenges of state/university partnerships, as well as ways to structure them. The discussion revolved around a series of questions, which can be found here. Nolin discussed Hilltop’s nationally recognized eighteen-year partnership with the Maryland Department of Health and Mental Hygiene, the catalyst for the development of the partnership, what it looks like today, its structure, and the benefits and challenges of such state/university partnerships. To view the slides, click here. To learn more about Maryland’s partnership, contact Mike Nolin.

Posted 7/02/12

Hilltop Presents at American Health Lawyers Association Webinar

Hilltop Hospital Community Benefit Program Director Martha H. Somerville, JD, MPH, presented at the American Health Lawyers Association’s June 21, 2012, webinar titled Protecting Tax Exemption Under the ACA: Exploring New Requirements Related to Community Needs Assessments; Financial Assistance Policies; and Billing and Collection Policies and Procedures. Somerville’s presentation, titled Community Benefit in Context: Evolution to ACA §9007, provided an overview of the origins and evolution of charitable tax exemption, the community benefit standard, and current tax exemption requirements for nonprofit hospitals. Other webinar presenters were Julie A. Trocchio, Senior Director of Community Benefit and Continuing Care at the Catholic Health Association, and Jessica Curtis, Esquire, Project Director of Community Catalyst’s Hospital Accountability Project. The session was moderated by Thomas Hyatt, Esquire, of SNR Denton. To view the presentation, click here. To read the supporting brief, click here.

Posted 6/25/12

New Publication Explores Somatic Care in Women with Mental Health and Substance Use Disorders

Hilltop Senior Research Analyst Michael T. Abrams, MPH, is the first author and Hilltop Director of Health Services Policy and Research Cynthia Boddie-Willis, MD, MPH, is a co-author of an article titled Cervical Cancer Screening and Acute Care Visits Among Medicaid Enrollees With Mental and Substance Use Disorders that now is electronically available in pre-print version at the Psychiatric Services website. The article discusses the methodology and findings of a study that compared rates of cervical cancer screening and acute care (primary or gynecological) visits among women enrolled in Maryland's Medicaid program in 2004-2005 with and without a diagnosis of psychosis, substance use disorder, bipolar disorder or mania, or depression. Researchers found that in Maryland Medicaid, the odds of cancer screening and related acute care visits were greater for women with major mental disorders compared with women in the control group. For women with substance use disorders, however, screening was reduced and acute care visits were similar compared with women in the control group. This work suggests that while women with serious mental disorders in Maryland Medicaid receive preventative somatic care on par with controls, those with substance use disorders (addictions) seem at higher risk for the absence of such care. To view the abstract and access the article, click here. For more information, contact Michael Abrams.

Posted 6/07/12

Hilltop Presents at National Network of Public Health Institutes Conference

Hilltop Hospital Community Benefit Program Director Martha H. Somerville, JD, MPH, presented as part of a plenary town hall panel in a session titled Community Health Assessments: Opportunities for Collaboration at the National Network of Public Health Institutes (NNPHI) Annual Conference of May 23, 2012 in New Orleans, Louisiana. In her presentation, Partnerships for Community Needs Assessment−Community Benefits & Health Department Accreditation, Somerville outlined community benefit requirements under the Affordable Care Act (ACA) and related reporting requirements (Internal Revenue Service Form 990, Schedule H). The discussion focused on the ACA’s community health needs assessment requirement, how it can relate to public health department accreditation, and how Public Health Institutes can facilitate community partnerships of hospitals, health departments, and community-based organizations to conduct needs assessment and community health improvement planning, as well as develop initiatives to improve community health. To view the presentation, click here.

Posted 5/29/12

Hilltop Presents at CHCS Meeting on Integrated Long-Term Care

Hilltop Director of Special Studies Ian Stockwell, MA, gave a presentation at the Center for Health Care Strategies (CHCS) meeting, entitled State Planning for a High Performance Health System For Medicare/Medicaid Dual Eligibles and Implementing Innovations, which was held March 6 and 7, 2012 in Alexandria, Virginia. At the meeting, CHCS brought states together to focus on integrated care program development and improving the delivery of long-term services and supports (LTSS). In his presentation, Data vs. Dollars: The Interplay Between Analytical Methods and Rate Setting for Community Care, Stockwell discussed the use of predictive analytics and risk assessment to facilitate care in the community. In addition, he shared strategies for structuring reimbursement rates in a manner that encourages community-based care.

Hilltop Senior Research Analyst Michael Abrams, MPH, presented the findings of a study to elucidate coordination of care targets within Maryland's Medicaid population of persons with substance use disorders. The presentation was made to Baltimore Substance Abuse Systems, Inc. (bSAS) leadership and their consultants on February 24th, 2012. BSAS, the public substance use authority in Baltimore City, is funding this work. The study uses a novel statistical technique – Latent Class Analysis (LCA) – to discern mutually exclusive and relatively homogenous subgroups of Medicaid enrollees with such disorders. This implementation of the LCA technique relies on Medicaid administrative data corresponding to demographic, enrollment category, utilization, state expenditure, and diagnostic information in order to identify 10 subgroups of persons with substance use disorders of various types. The results of this study will guide future work regarding the design of "medical homes" for such persons, with special focus on the full implementation of the Affordable Care Act. Abrams is the lead on this work, with substantial research and programming support by Policy Analyst Seung Ouk Kim, PhD, and Senior Programmer Jayne Miller, B.S. To view the full presentation with supporting tabulations and definitions, click here.

The Hilltop Institute's Hospital Community Benefit Program has just released its third issue brief, entitled Hospital Community Benefits after the ACA: Partnerships for Community Health Improvement. The brief discusses a variety of options for collaboration in assessment, planning, priority setting, and implementation of health improvement initiatives; provides examples of diverse models already in place; and examines their impact on the communities in which they occur. To view the Bulletin, click here. To view the issue brief, click here.

Posted 02/23/12

Bulletin: Direction of Hilltop's Hospital Community Benefit Program Changes Hands

The Hilltop Institute is pleased to announce that Martha H. Somerville, JD, MPH, is the new director of its Hospital Community Benefit Program. Somerville is a senior policy analyst at Hilltop and has devoted much of her time to the program since its inception in 2010. She is co-author of the program’s issue briefs and is actively involved in the program’s newsletter.
To view the bulletin, click here.

Posted 1/04/12

Hilltop Presents at GSA's 64th Annual Scientific Meeting

Hilltop Director of Special Studies Ian Stockwell, MA, gave a poster presentation at the Gerontological Society of America's (GSA's) 64th Annual Scientific Meeting, which was held November 18 through 22, 2011, in Boston, Massachusetts. This conference brought together more than 4,000 of the brightest in the field of aging for a combined 500 symposia, paper, and poster presentations. To view Stockwell's poster, which describes Hilltop’s analysis of Maryland’s Money Follows the Person program, click here.

Posted 11/29/11

Hilltop Presents at 27th National HCBS Conference

Hilltop staff made two presentations at the 27th National Home and Community-Based Services (HCBS) Conference in Washington, DC, which took place from September 11 through 14, 2011.

Senior Policy Analyst Ian Stockwell, MA, gave a presentation with staff from the Maryland Department of Aging and the Maryland Department of Health and Mental Hygiene. This presentation, entitled Driving HCBS Innovation through Data and Metrics, discussed HCBS beginnings and momentum including advocacy and costs, HCBS waivers, Aging and Disability Resource Centers (ADRCs), and Money Follows the Person (MFP); data and metrics to build community-based services; and using metrics to move forward. Stockwell focused on Hilltop’s research on utilization and expenditures of both institutional services and HCBS in Maryland, as well as on the Quality of Life Survey Hilltop conducted, to discuss how metrics were used and how they can be used going forward.

Hilltop's Research Presented at NIMH Conference

Three research works were presented at the National Institute of Mental Health's 21st Conference on Mental Health Services Research, held in Washington DC, on July 27-28, 2011. Improving Inpatient Psychiatric Payment Using Modified APR-DRGs (authors: Donald Steinwachs, David Salkever, Norbert Goldfield, Anthony Lehman, Michael Kaminsky, Michael Abrams, Elizabeth Skinner, Maureen Fahey, Hamid Fakhraei) was a presentation which summarized findings from a study of the costs associated with inpatient psychiatric events, as well as correlates to those costs which might be used to engineer case-rate billing procedures. Imminent Enrollment Lapses in Medicaid after Psychiatric Hospitalizations in Young Adults (authors: Maryann Davis, Michael Abrams, Lawrence Wissow, Eric Slade) was a poster presentation on work that reviewed factors associated with Medicaid disenrollment in the wake of discharges from an inpatient psychiatric event for persons age 18-26, which used classification and regression tree (CART) and probit analyses to focus on the strongest predictors of such disenrollment. Effects of Medicaid Lapses on Young Adults' Use of Outpatient Services after Inpatient Stays, (authors: Eric Slade, Larry Wissow, Maryann Davis, Michael Abrams) was a slide presentation on a review of correlates between Medicaid enrollment discontinuities and outpatient mental health service use and among young adults age 18-26 who experienced a inpatient psychiatric event. For more information, contact Hilltop Senior Research Analyst Michael Abrams.

Posted 08/01/11

Hilltop Participates in CDC Forum on Community Health Needs Assessment

Donna Folkemer, MA, director of Hilltop’s Hospital Community Benefit Program, was a panelist at a recent public forum sponsored by the Centers for Disease Control and Prevention, entitled Best Practices for Community Health Needs Assessment and Implementation Strategy Development: A Review of Scientific Methods, Current Practices, and Future Potential, on July 12, 2011, in Atlanta, Georgia. Folkemer participated on the panel, entitled Reporting and Oversight: State Level Oversight, with Lois Johnson from the Massachusetts Office of the Attorney General and Gianfranco Pezzino from the Kansas Health Institute. Folkemer began by asking the audience to consider how best to create a public sector oversight role that can lead to desired outcomes for community health improvement. She noted that state approaches to reporting and oversight vary significantly and that there is not yet an evidence base to direct states as they define community benefit measures. She said that the Affordable Care Act is leading states to identify benchmarks of success as they design health insurance exchanges, health information technology systems, etc., stating that the same attention should be given to benchmarking in the community benefits arena. “Benchmarks are designed to measure the rate of change, and it will be important for states to find creative and practical ways to measure change in the practices of nonprofit hospitals to assure good community health outcomes,” Folkemer said.

Posted 07/19/11

Bulletin: Hilltop Hosts Symposium on Community Health Needs and the ACA

The Hilltop Institute is pleased to announce the success of its fifth invitational symposium, Responding to Community Health Needs within the Framework of the Affordable Care Act (ACA), which convened on June 28, 2011. To learn more about the speakers, view the presentations, and see the agenda, click here. To view the bulletin, click here.

Posted 07/13/11

Hilltop Presents at AcademyHealth Annual Research Meeting (ARM)

The Hilltop Institute had a visible presence at this year’s AcademyHealth ARM, held June 11-14 in Seattle, Washington.

On June 11, Hilltop and the Department of Health Management and Policy at Saint Louis University co-sponsored a Community Benefit preconference. Hilltop Hospital Community Benefit Program Director Donna Folkemer, MA, spoke about current policy challenges for states, discussing issues for states to help inform the interpretation and implementation of Section 9007 of the Affordable Care Act, which is the subject of the program’s second issue brief, Hospital Community Benefits after the ACA: Building on State Experience. To view the presentation, clickhere.

On June 12, Hilltop Senior Policy Analyst Karen E. Johnson, MS, gave a poster presentation entitled Using Propensity Score Matching Techniques to Establish Treatment/Control Groups to Assess Medicare and Medicaid Service Use, which was also authored by Hilltop Director of Special Research and Development Anthony M. Tucker, PhD, and UMBC Assistant Professor Yi Huang, PhD. The poster described the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid long-term services and supports (LTSS) via home and community-based (HCBS) waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses that are based on observational and/or administrative data.

On June 12, Hilltop Policy Analyst Laura Spicer gave a presentation at a session on Addressing Cost and Affordability in Public Programs: Implications for the Affordable Care Act. Her presentation, entitled Evaluating Small Group Employer Participation in New Mexico’s SCI Program, discussed findings from a Hilltop study funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) initiative. The study identified factors associated with small group employer participation in New Mexico’s State Coverage Insurance (SCI) program.

On June 14, Hilltop Director of Medicaid Policy Studies David Idala, MA, gave a presentation at a session on outreach and enrollment that examined how states could reach newly eligible populations under the Affordable Care Act (ACA). His presentation, entitled Maryland’s Kids First Act: The Use of Tax Forms to Identify Medicaid/CHIP-Eligible Children, discussed the use of state income tax forms to identify children who are eligible for, but not enrolled in, Medicaid, and the lessons learned so far from the Maryland Kids First outreach initiative that could help states as they implement the ACA.

Finally, Hilltop Director of Long-Term Services and Supports Cynthia H. Woodcock, MBA, and Maryland Department of Health and Mental Hygiene Deputy Secretary of Finance and former Hilltop Executive Director Charles J. Milligan, Jr., JD, MPH, presented the keynote address, Rebalancing Long-Term Services and Supports: Progress to Date and a Research Agenda for the Future, at this year’s Long-Term Care Colloquium on June 14. Woodcock and Milligan presented highlights from their commissioned paper focusing on the success, to date, of rebalancing long-term care toward community settings and the implications of provisions in the Affordable Care Act for future rebalancing efforts.

Posted 06/20/11

Hospital Community Benefit Program Releases First Newsletter

The Hilltop Institute’s Hospital Community Benefit Program has just released its first newsletter, Community Benefit Briefing. The newsletter is meant to assist state and local policymakers to understand and monitor hospital community benefit activities. This issue highlights the Catholic Health Association’s discussion draft of a new guide, Oregon House Bill 2392, a preconference to the AcademyHealth Annual Research Meeting, and the program’s second and third issue briefs. To view the newsletter, click here. To subscribe, click here.

Posted 05/19/11

Hilltop to Present Colloquium Keynote at AcademyHealth Annual Research Meeting

Hilltop Director of Long-Term Services and Supports Cynthia H. Woodcock, MBA, and Maryland Department of Health and Mental Hygiene Deputy Secretary of Health Care Financing and former Hilltop Executive Director Charles J. Milligan, Jr., JD, MPH, will present the keynote address at this year’s Long-Term Care Colloquium at the AcademyHealth Annual Research Meeting on June 14, 2011, in Seattle, Washington. In this colloquium, entitled Building Bridges: Making a Difference in Long-Term Care, Woodcock and Milligan will present highlights from their commissioned paper, focusing on the success, to date, of rebalancing long-term care toward community settings and the implications of provisions in the Affordable Care Act for future rebalancing efforts.

Posted 05/19/11

Hilltop to Co-Sponsor Preconference to AcademyHealth Annual Research Meeting

The Hilltop Institute and the Department of Health Management and Policy at Saint Louis University are co-sponsoring a Community Benefit Preconference to the AcademyHealth Annual Research Meeting in Seattle, Washington, on June 11, 2011. The purpose of this preconference, entitled Moving Forward with Evidence-Based Policy and Practice, is to facilitate collaboration between health care delivery systems—particularly hospital community benefit programs—and the communities they serve. Hilltop Hospital Community Benefit Program Director Donna Folkemer, MA, will speak about policy challenges and opportunities for states as §9007 of the Affordable Care Act is implemented. This is the subject of the program’s second issue brief, Hospital Community Benefits after the ACA: Building on State Experience. The event is supported by the Robert Wood Johnson Foundation MATCH Program.

The Hilltop Institute’s Hospital Community Benefit Program has just released its second issue brief, entitled Hospital Community Benefits after the ACA: Building on State Experience. The brief takes a closer look at three aspects of community benefits affected by the Affordable Care Act (ACA) §9007, “Additional Requirements for Nonprofit Hospitals”: community health needs assessment; hospital financial assistance and billing and collection policies; and community benefit reporting and oversight strategies. The brief considers each of these requirements against a backdrop of federal and state experience and practice. The view the bulletin, click here. To view the brief, click here. To learn more about Hilltop’s Hospital Community Benefit Program, click here.

Posted 04/28/11

Hilltop Presents at International Mental Health Policy and Economics Conference

Hilltop Senior Research Analyst Michael T. Abrams, MPH, presented a paper at the Tenth Workshop on Costs and Assessment in Psychiatry on March 27, 2011, in Venice, Italy. The international workshop was organized in collaboration with the World Health Organization (WHO), the World Psychiatric Association (WPA), and national governmental institutions, such as the US NIMH, the UK Department of Health, and the Italian Ministry of Foreign Affairs. Abrams’ presentation, entitled Correlates toAntipsychotic Medication Switching among U.S. Medicaid Clients with Schizophrenia, described a method of summarizing administrative data to quantify switching events among persons with schizophrenia who use common medications for treating that illness. The work also explored demographic and drug type correlations to such medication switching. David S. Salkever, PhD, Professor of Public Policy at UMBC, was a co-author on this work.

Salkever and Abrams presented a second paper at this same conference entitled Antipsychotic Switching and Heterogeneity in Treatment Costs for Persons with Schizophrenia in the Maryland Medicaid Program. This study examined cost impacts of different antipsychotic drugs used to treat persons with schizophrenia, and furthermore considered the impact of switching medication vs. stable therapy. The work included comparisons of standard ordinary least squared (OLS) regressions with instrumental variable approaches to consider the differential impacts of individual antipsychotics, as well as conventionals vs. atypicals. For more information, contact Michael Abrams.

The Hilltop Institute co-sponsored an AARP Solutions Forum entitled Launching Insurance Exchanges: What Are States Doing? on April 4, 2011, in Washington, DC. The forum explored the variety of ways states are moving ahead with plans for the launch of state insurance exchanges as part of the Affordable Care Act. Hilltop’s former Executive Director Chuck Milligan gave an overview of key issues: structuring governance and oversight; avoiding adverse risk selection; determining plan selection/participation; integration with public programs and private market; helping individuals and employers navigate; protecting the public (transparency and rewarding and improving quality of care); and funding of exchanges. To view a webcast of the forum, click here.

Posted 04/05/11

Hilltop Presents at ASPA Annual Meeting

Hilltop Deputy Director Michael Nolin participated in a panel discussion entitled Health Reform 2011: Where are we now? at the Annual Meeting of the American Society of Public Administrators on March 14, 2011, in Baltimore, Maryland. In his presentation, which focused on Maryland’s reform efforts, Nolin gave an overview of Maryland’s reform preparation process and described the Maryland Health Care Reform Coordinating Council (HCRCC) and the work Hilltop performed as staff for the HCRCC; described Hilltop’s financial modeling tool that determined that Maryland could save $829 million in implementing federal health reform; and discussed the major health reform issues that remain unresolved. To view the presentation, click here. To learn more about Hilltop’s financial modeling tool, contact Michael Nolin.

Posted 03/16/11

Hilltop Presents to Ohio Decision Makers on Innovations in Integrated Care and on Medicaid in an Era of Health Reform

Hilltop Executive Director Charles Milligan traveled to Columbus, Ohio, on February 23, 2011, to give two presentations to decision makers. Milligan discussed opportunities to better serve persons dually eligible for Medicare and Medicaid (dual eligibles) in his presentation to the Ohio Association of Health Plans and the Ohio Association of Area Agencies on Aging (O4A) entitled Innovations in Integrated Care. He discussed the importance of integrating long-term services and supports for this population; the results of Hilltop’s research on Medicare/Medicaid cross-payer effects for dual eligibles that found that Medicare and Medicaid financing do not align to promote home and community-based services (HCBS) and that the HCBS waiver is only cost-effective (at the individual level) for Medicaid when it truly avoids a nursing home placement; and new opportunities for states under the Affordable Care Act to better serve dual eligibles. To view the presentation, click here. To view a press release on the presentation, click here. To access Hilltop’s reports on Medicare/Medicaid cross-payer effects, click here. To view a video clip of Milligan discussing this issue, click here.

Also on February 23, Milligan gave a presentation entitled Medicaid Basics in an Era of Health Reform to two groups—Ohio state legislators and their staff, and other stakeholders—sponsored by the Health Policy Institute of Ohio. In this legislative briefing, Milligan gave an overview of Medicaid and discussed budget tools used by states to manage Medicaid programs, which are important for lawmakers to understand when developing and assessing budget and program proposals. Milligan also addressed the implications of federal health reform for state Medicaid programs and the changing state/federal relationship. To view the presentation, click here.

Posted 02/24/11

Hilltop Participates in IOM Public Health Workshop

The Hilltop Institute's Health Services Policy and Research Director Cynthia Boddie-Willis, MD, MPH, was a discussant at an Institute of Medicine (IOM) report dissemination workshop, entitled For the Public’s Health: The Role of Measurement in Action and Accountability, on February 17, 2011, in Washington, DC. Boddie-Willis participated in a discussion on the interface between clinical care and public health, which addressed recommendations #4 and #5 of the first report of the IOM Committee on Public Health Strategies to Improve Health.

The Hilltop Institute’s Hospital Community Benefit Program released its first issue brief, entitled Hospital Community Benefits after the ACA: The Emerging Federal Framework. The brief provides historical background on federal hospital community benefit policy; outlines the new requirements described in the Affordable Care Act (ACA); and identifies new challenges and opportunities for state and federal decision makers as they begin to develop responses to the new federal requirements. The issue brief is the first in a series, funded by the Robert Wood Johnson Foundation, to be published over three years. To view the bulletin, click here. To view the issue brief, click here.

Posted 01/11/11

Final Report on Health Reform in Maryland Released

The Maryland Health Care Reform Coordinating Council (HCRCC) released its final report on January 10, 2011. The report is the result of the HCRCC’s efforts since March 2010, when it was created by Maryland Governor Martin O’Malley to make recommendations regarding Maryland’s implementation of the Affordable Care Act (ACA). This final report sets forth a blueprint for Maryland’s implementation of health care reform and includes an overview of the ACA, with a description of the findings of the HCRCC, which were published in its interim report released in July 2010. It also: describes the already-established foundation for reform in Maryland; summarizes the work and process of the HCRCC; identifies the major challenges and opportunities presented by implementation; identifies the necessary investments to ensure success; and identifies 16 recommended short- and long-term action items on how federal reform can be implemented most effectively. The HCRCC was co-chaired by the Honorable Anthony G. Brown, Lieutenant Governor of Maryland, and John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene. The lead staff for the HCRCC were Charles Milligan, Hilltop's executive director, and Alice Burton, principal at Riverside Consulting, LLC. Beyond providing various forms of staff support, Hilltop’s researchers conducted an in-depth analysis of the provisions of the ACA and developed a financial model to project Maryland’s costs and savings associated with implementing health reform. To learn more about the HCRCC and view the interim and final reports, click here. To learn more about Hilltop’s financial model, contact Charles Milligan.

The Hilltop Institute at UMBC has just released a new issue brief entitled Overcoming Interagency Data-Sharing Barriers:Lessons from the Maryland Kids First Act that describes interagency data-sharing barriers that researchers and state officials encountered as they implemented and evaluated the Maryland Kids First Act outreach initiative. The brief provides an overview of strategies used to identify uninsured children who are eligible for public insurance programs; an update on Maryland’s tax-based outreach program, including a description of the interagency data-sharing barriers encountered and their resolution; a discussion of new data-sharing and outreach opportunities outlined in the Affordable Care Act (ACA); and a discussion of lessons for other states.
To view the bulletin, click here. To view the issue brief, click here.

Posted 01/06/11

Hilltop Research Findings Published in HSR Journal

The findings of a Hilltop research project that identified factors associated with small group employer participation in New Mexico’s State Coverage Insurance (SCI) program have been published in an article in the December 9, 2010, online issue of HSR Journal. Entitled Small Group Employer Participation in New Mexico’s State Coverage Insurance Program: Lessons for Federal Reform, the article discusses administrative and cost issues that small employers considered when deciding whether to participate in the SCI program. It concludes that administrative and cost barriers to participation in SCI reported by employers suggest that the tax credit offered to small businesses under new federal provisions, which merely offsets the employer portion of premium, could be more effective if accompanied by additional supports to businesses. The study was partially funded by a grant to Hilltop and its partner, the New Mexico Human Services Department, from the Robert Wood Johnson Foundation State Health Access Reform Evaluation (SHARE). To view the article, click here. Findings of the study were also published in two issue briefs: one from Hilltop (click here) and one from SHARE (click here).

Hilltop Executive Director Charles Milligan gave a presentation before the Medicaid and CHIP Payment and Access Commission (MACPAC) at its monthly commission meeting on December 10, 2010, in Washington, DC. The presentation, entitled Medicaid and Medicare Resource Use For Dual Eligibles in Maryland, addressed the issue of coordinating long-term care for persons eligible for both Medicare and Medicaid (dual eligibles). In his presentation, Milligan discussed Hilltop’s research on Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services. To view the presentation, click here. To learn more about Hilltop’s research on Medicare/Medicaid cross-payer effects, click here.

Posted 12/13/10

Hilltop Presents at NCSL Fiscal Leaders Seminar

Hilltop Deputy Director Michael Nolin participated on a panel at the National Conference of State Legislatures (NCSL) Fiscal Leaders Seminar on December 9, 2010, in Phoenix, Arizona. The session, entitled State Fiscal Implications of Federal Health Reform, addressed what states are doing to examine the expected state fiscal implications of the Affordable Care Act. The panel discussed the areas where increased and decreased costs to Vermont and Maryland are anticipated and the assumptions and factors used to come to those conclusions. Nolin’s presentation discussed the financial analysis that Hilltop performed for the Maryland Health Care Reform Coordinating Council, which determined that Maryland would save $829 million in the next ten years by enacting federal health reform. To view the presentation, click here. To learn more about Hilltop’s financial modeling tool, contact Michael Nolin.

Posted 12/13/10

Hilltop Presents Keynote at IGPA State Summit 2010

Hilltop Executive Director Charles J. Milligan was the luncheon keynote speaker for the University of Illinois Institute of Governmental and Public Affairs (IGPA) State Summit 2010: Reforming Medicaid in Illinois on December 7, 2010, in Champaign, Illinois. Milligan’s keynote address, entitled Transforming Medicaid in an Era of Health Reform: State Efforts to Thrive While Hoping to Survive, discussed economic trends and Medicaid; health reform; budget tools; and the changing state/federal relationship. The presentation deals with national trends and could be helpful to all states as they struggle with ensuring access to health services in a difficult economic environment. To view the presentation, click here.

Posted 12/10/10

Hilltop Researchers Present at APHA Annual Meeting

Hilltop Director of Clinical and Quality Management Annette Snyder, PhD, and Senior Research Analyst Michael Abrams, MPH each made presentations at the 138th American Public Health Association (APHA) Annual Meeting held November 6 through 10, 2010, in Denver, Colorado. Snyder’s presentation, entitled The Impact of Selected Demographic, Mental Health and Geographic Measures on Discharge From Nursing Homes Among Working-Age Adults in Maryland, discussed a study that examined factors associated with discharge to the community for working-age adults admitted to Maryland nursing homes over a 5-year period. The study found that the strongest factors related to discharge to the community were an individual's expressed preference for discharge and perceived support for community discharge. To view the presentation, click here. Abrams made a presentation entitled Cervical Cancer Screening and Gynecologic Visit Rates for Medicaid Enrollees with Mental and Substance Use Disorders. Abrams discussed the findings of a study that assessed PAP screening and gynecological visit rates experienced by women with non-affective psychosis versus other women with substance use disorder (SUD), bipolar or unipolar depression, or the absence of any of these illnesses (controls). The study found that women with psychosis or depression were more likely to receive PAP screening versus controls; and women with SUD with or without psychosis demonstrated reduced screening rates. To view the presentation, click here. In addition, Abrams presented a poster on another study, entitled Alternative and “Off-Label” Uses of Antipsychotic Medications in Medicaid, which used Medicaid administrative data from a single state (Maryland) and year (7/2000 to 6/2001) to estimate rates of alternative uses for antipsychotics. This study found a substantial alternative use of antipsychotics, especially for mood disorders and suggested distinctive patterns for the most experienced mental health care providers in alternative use of these medications. To view the poster presentation, click here.

Posted 11/11/10

Bulletin: Second Issue Brief Released, Highlighting Findings from Evaluation of New Mexico SCI Program

The State Health Access Reform Evaluation (SHARE) has released an issue brief, entitled Participation in the New Mexico State Coverage Insurance (SCI) Program: Lessons from Enrollees. This is the second of two issue briefs that present results from a study of small business participation in SCI conducted by The Hilltop Institute. The study identifies the characteristics of non-sponsored enrollees in SCI and shares lessons learned about employer sponsorship of enrollees in SCI and similar public/private partnerships. To view the bulletin, click here.

Posted 11/08/10

Hilltop Presents at Focus on Reform Meeting

Hilltop Executive Director Charles Milligan participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on October 29, 2010, in Washington, D.C. This meeting, the seventh of the Focus on Reform series providing an in-depth look at various components of the Affordable Care Act (ACA) and related implementation and operational issues, was entitled Medicaid Long-Term Services and Supports (LTSS) Provisions in PPACA. The session provided an overview of the Medicaid LTSS provisions enacted as part of the ACA, including the Community First Choice and Section 1915(i) state plan options; and the balancing incentive payments (BIP) and Money Follows the Person (MFP) programs, among others. Speakers described the provisions; strategies being employed by the Centers for Medicare & Medicaid Services (CMS) to assist states implement the various options, and opportunities and challenges facing states in implementation of the provisions. In his presentation, Milligan discussed the growth in Medicaid expenditures for LTSS; presented the results of a Hilltop study of Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services (HCBS); described state and federal opportunities and barriers; and forecasted the take-up of LTSS options in the ACA. To view the presentation, click here.

Posted 11/05/10

Bulletin: Hilltop Launches National Hospital Community Benefit Program

The Hilltop Institute at UMBC is proud to announce the opening of its new Hospital Community Benefit Program. Made possible by the generous support of the Robert Wood Johnson Foundation and the Kresge Foundation, the program will be the first ever central resource created specifically for state and local policymakers to improve the reporting and evaluation of tax-exempt hospitals’ community benefit activities. The Hospital Community Benefit Program will be a resource to state and local health departments, hospital regulators, legislators, revenue collection and budgeting agencies, and hospitals, as each entity works to improve the transparency, comparability, fairness, and effectiveness of the community benefits delivered by tax-exempt hospitals. To view the bulletin, click here.

Posted 10/26/10

Hilltop Presents at UMBC Public Policy Forum on Health Reform

Hilltop Executive Director Charles Milligan was one of three experts who spoke at the UMBC Public Policy Forum entitled Health Care Reform: What Will It Mean to Maryland?, held October 22, 2010, in Baltimore, Maryland. In his presentation, entitled What Federal Health Care Reform Legislation Means to States, Milligan gave an overview of the new federal health reform legislation, the Affordable Care Act (ACA), and discussed its implications for states regarding Medicaid; exchanges; insurance-related issues; information technology; long-term services and supports; workforce issues; and preventive services and public health. Other speakers included Maryland Department of Health and Mental Hygiene Secretary John Colmers, who spoke about Maryland’s implementation plans and the Health Care Reform Coordinating Council, which he co-chairs; and Paul Fronstin, Senior Research Associate at the employee Benefit Research Institute, who spoke about the ACA’s implications for employers and employees. About 100 people from across Maryland were in attendance. Hilltop co-sponsored the forum with the UMBC Department of Public Policy, the Maryland Institute for Policy Analysis and Research, and the Annie E. Casey Foundation. To view Milligan’s presentation, click here. To view Colmers' presentation, click here.

Posted 10/23/10

Hilltop Presents at AHIP 2010 Medicaid Conference

Hilltop Executive Director Charles Milligan gave a presentation at the closing general session of the American Health Insurance Plans (AHIP) Medicaid Conference on September 16, 2010, in Washington, DC. The session, entitled Opportunities for Medicare/Medicaid Integration: Serving Dual-Eligible Beneficiaries, addressed issues surrounding coordination of coverage and seamless integration of benefits for dually eligible individuals. Milligan's presentation painted a portrait of dual eligibles, using Maryland as an example; gave an overview of cross-payer effects for dual eligibles and of Hilltop's research on cross-payer effects for dual eligibles in Maryland; and discussed the study's findings and policy implications. To view the presentation, click here.

Posted 09/21/10

Bulletin: Hilltop to Co-Sponsor Public Policy Forum on Health Care Reform on October 22, 2010

This public policy forum will describe how Maryland plans to implement health care reform, with a focus on the impact of expanded coverage for working families. Speakers include Charles Milligan, Executive Director of The Hilltop Institute; John Colmers, Secretary of the Maryland Department of Health and Mental Hygiene; and Paul Fronstin, Senior Research Associate for the Employee Benefit Research Institute. Public Policy Professor Nancy Miller will moderate. To view the bulletin, click here.

Posted 09/07/10

Interim Report on Health Care Reform Implementation in Maryland Released

The Maryland Health Care Reform Coordinating Council (HCRCC) released its Interim Report at a press conference in Baltimore on July 26, 2010. The report is the result of the HCRCC’s efforts since March 2010, when it was appointed by Maryland Governor Martin O’Malley to make recommendations regarding Maryland’s implementation of the recently enacted federal health reform legislation, the Patient Protection and Affordable Care Act (PPACA). The report includes: an overview of the federal law and its general implications for reform in Maryland; the role and mission of the HCRCC; the opportunities and challenges presented by reform implementation and the principles by which it must be guided; the state’s unique health care landscape and regulatory environment against which implementation decisions must be made; the projected fiscal impact of reform over the next decade; the workgroup process through which the HCRCC will formulate its recommendations on the decisions most critical to Maryland’s success; and a timeline for planning and key activities. The HCRCC is co-chaired by the Honorable Anthony G. Brown, Lieutenant Governor of Maryland, and John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene. The HCRCC is staffed by Charles J. Milligan, The Hilltop Institute’s executive director, and Alice Burton, principal at Riverside Consulting, LLC. To support the HCRCC’s work, Hilltop researchers conducted an in-depth analysis of the provisions of PPACA and developed a financial model to project Maryland’s costs and savings associated with implementing health care reform. The model, based on current assumptions, predicts that health care reform could save Maryland an estimated $829 million in health care costs in the next decade. To learn more about the HCRCC and view the report, visit www.healthreform.maryland.gov/interimreport.html.

Posted 07/27/10

Hilltop Presents at State Health Access Program Grantee Meeting

Hilltop Executive Director Charles Milligan presented the luncheon keynote address at the second State Health Access Program (SHAP) All Grantee meeting on July 26, 2010, in Arlington, VA. Milligan’s keynote, entitled Implementation of the Affordable Care Act, focused on state opportunities and major decisions related to federal health reform and offered suggestions for the role that SHAP grantees could play in their respective states. To view the presentation, click here.

Posted 07/26/10

Hilltop Presents at AcademyHealth Annual Research Meeting

Hilltop Executive Director Charles Milligan participated in a roundtable at the 2010 AcademyHealth Annual Research Meeting on June 28, 2010, in Boston, Massachusetts. The session, Balancing LTC: Can More Home and Community-Based Support Save Money While Improving Care?, explored the cost effectiveness of the most recent generation of home and community-based services (HCBS) programs and included the interaction between the Medicare and Medicaid programs, workforce concerns, and the need to better measure effectiveness. Milligan’s presentation, Dual Eligibles in Maryland, gave an overview of Hilltop’s research on cross-payer effects for dual eligibles in Maryland, provided the results of the study, and discussed some implications for policy. To view the presentation, click here. To access the full report, click here.

Posted 06/29/10

Hilltop Presents to Congressional Staff on Long-Term Services and Supports

Hilltop Senior Research Analyst Harriet L. Komisar participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on June 18, 2010. This meeting, the third of the Focus on Reform series providing an in-depth look at various components of the Patient Protection and Affordable Care Act (PPACA) and related implementation and operational issues, was entitled Long-Term Services and Supports (LTSS) and the CLASS Act. Komisar’s presentation discussed financing sources for LTSS. To view the presentation, click here.

Posted 06/21/10

Hilltop Presents at National Medicaid Conference

Hilltop Long-Term Supports and Services Director Cynthia H. Woodcock gave a presentation at the National Medicaid Congress pre-conference symposium entitled Managing Current and New Dual Eligibles on June 7, 2010. In the presentation, entitled Dual Eligibles in Nursing Facilities and Other Long-Term Care Settings, Woodcock discussed system coordination issues for dual eligibles in Maryland long-term care settings from a fiscal and service perspective and presented the opportunity for a coordinated care program; described New Mexico’s Coordination of Long-Term Services (CoLTS) program, which Hilltop helped New Mexico develop; and discussed whether coordinated long-term care was more efficient. To view the presentation, click here.

Posted 06/16/10

Bulletin: Hilltop Releases Final Report in Series on Medicare/Medicaid Cross-Payer Effects

The Hilltop Institute has released a new report entitled, Cross-Payer Effects on Medicare Resource Use: Lessons for Medicaid Administrators. The report, authored by Anthony M. Tucker, PhD, and Karen E. Johnson, MS, is the fourth and final report in a series that explores the cross-payer effects of providing Medicaid long-term supports and services (LTSS) on Medicare acute care resource use. The report provides a summary of the initial work of a study, described more fully in the first three reports, with an emphasis on lessons that state Medicaid administrators should consider as they move toward more formal programs of integrated care for persons dually eligible for Medicare and Medicaid (or duals, for short). The view the report, click here. To view the bulletin, click here.

Posted 06/08/10

Hilltop Presents to Congressional Staff on Health Reform

Hilltop Executive Director Charles Milligan participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on May 7, 2010. This meeting, the first in a new Focus on Reform series providing an in-depth look at various components of the Patient Protection and Affordable Care Act (P.L. 111-148) and related implementation and operational issues, was entitled Medicaid Coverage Expansions. Milligan’s presentation discussed state implementation requirements as well as the opportunities and challenges the coverage expansions present for states. To view the presentation, click here.

On March 24, 2010, Maryland Governor Martin O’Malley signed an Executive Order that created the Health Care Reform Coordinating Council (HCRCC) to make recommendations regarding Maryland’s implementation of the federal health reform legislation. The HCRCC, co-chaired by Lieutenant Governor Anthony Brown and Department of Health and Mental Hygiene Secretary John Colmers, has contracted with The Hilltop Institute to provide analysis and technical assistance throughout the HCRCC’s work, as well as to develop the two reports mandated by the Executive Order. To learn more about the HCRCC, click here.

Posted 04/28/10

Hilltop Completes Resource Mapping Project for the State of Rhode Island

The Hilltop Institute carried out a resource mapping project for the state of Rhode Island as part of the state’s efforts to create a more accessible system of long-term services and supports under their federal Real Choice Systems Transformation grant. Hilltop interviewed state agency staff on their perceptions of service gaps and barriers to accessing the system of long-term services and supports; conducted a survey of providers of long-term services and supports in the state about current and future capacity to serve Rhode Islanders; and constructed a rebalancing model for projecting utilization and expenditures for Medicaid long-term services and supports through 2030.

Click here to view Hilltop’s final report. Click here to view Hilltop’s presentation on the final report. Click here to view Hilltop’s presentation on the rebalancing model.

Posted 04/01/10

Hilltop Analyses Lead to Increased Access to Care

Hilltop’s work for the Maryland Health Services Cost Review Commission (HSCRC) analyzing Maryland hospitals’ financial assistance and debt collection policies informed the modification of a law enacted in 2009 that requires acute care hospitals to establish state-approved debt collection policies and provide medically necessary care to patients with family incomes below 150% of the federal poverty level (FPL). The legislation, taking effect October 1, 2010, applies the debt collection requirements to chronic care hospitals and requires hospitals to provide reduced-cost care to patients with family incomes below 500% of the FPL if they face financial hardship—medical debt incurred over a 12-month period that exceeds 25% of their income. This legislation will decrease the payment burden for those patients who are struggling financially, thus increasing access to care. Hilltop provided in-depth analyses of these policies and practices, provided consultation to the HSCRC work group that developed the recommendations for the Maryland legislature, and testified before the legislature to discuss its findings. To see the HSCRC report that includes Hilltop’s findings, click here.

Chuck Milligan Presents Paper at NGA State Summit on Health Reform

Hilltop Executive Director Chuck Milligan presented his paper, entitled Reshaping Medicaid, at the National Governors Association (NGA) State Summit on Health Reform on March 15, 2010, in Washington, DC. This invitational summit brought together four key stakeholders from each state—the Governor’s health policy advisor, the state’s Medicaid Director, the state’s Insurance Superintendant, and another individual selected at the state’s discretion—to explore and discuss health reform from the state perspective. The session, entitled Modernizing and Expanding Medicaid, focused on emerging opportunities and challenges in Medicaid, related to and independent of federal health reform. Following presentation of his paper, Milligan moderated a panel discussion that included Cindy Mann, Director of the Center for Medicaid and State Operations, Centers for Medicare and Medicaid Services; Carol Steckel, Commissioner of the Alabama Medicaid Agency; and Jason Helgerson, Medicaid Director, Wisconsin Department of Health Services. To view the conference proceedings, click here.

Posted 03/16/10

Hilltop Participates in 3rd Annual Medicaid Managed Care Summit

Hilltop Executive Director Charles J. Milligan, Jr., participated on a panel at the 3rd Annual Medicaid Managed Care Summit in Washington, DC on February 25, 2010. The summit examined policy changes, Health Care Reform, and funding opportunities, as well as explored strategic answers to the core challenges in managed care. The panel, entitled Establishing Coordinated LTSS [long-term supports and services] Programs: Solutions for Medicaid, States, and Consumers that Promote Improved Quality and Flexibility, brought together Milligan and other experts in long-term care who presented challenges and solutions for the largely unmanaged portions of state Medicaid budgets dealing with long-term care services from a fiscal, medical, and operations perspective with an emphasis on the perspective of seniors and people with disabilities. The discussion included: identifying the personal care needs of seniors and people with disabilities; public policy considerations for personal care that preserve independence and freedom; examples of successful State LTSS programs, including the New Mexico Coordination of Long-Term Services (CoLTS) Program, which Hilltop helped develop; and demonstrating how managed care can transform to coordinated LTSS. To view the panel slides, click here.

Posted 02/25/10

Hilltop Presents Research Findings at SHARE Webinar

Hilltop Medicaid Policy Studies Director David Idala, MA, discussed Maryland's strategy for targeting public program enrollment efforts at a webinar hosted by the State Health Access Reform Evaluation (SHARE) on February 24, 2010, entitled Using Income Tax Information to Target Medicaid and CHIP Outreach.Idala’s presentation, entitled Maryland’s Kids First Act: Using Tax Forms to Identify Medicaid/CHIP-Eligible Children, discussed the findings of Hilltop’s evaluation and reviewed data collection, outreach strategies, impact on enrollment, and lessons learned. The evaluation was funded by SHARE, a national program of the Robert Wood Johnson Foundation®, with direction by the State Health Access Data Assistance Center at the University of Minnesota School of Public Health. To view the presentation, click here. To access the SHARE Issue Brief on the evaluation’s results, click here. To listen to the webinar, click here.

The Hilltop Institute has released a new report entitled, Examining the Medicare Resource Use of Dually Eligible Medicaid Recipients. The report, authored by Anthony M. Tucker, PhD, Karen E. Johnson, MS,
Yi Huang, PhD, and Tonya Brewer, MPH, is the third in a series that explores the cross-payer effects of providing Medicaid long-term supports and services (LTSS) on Medicare acute care resource use. The report reflects an exploratory analysis of the relationships between Medicare and Medicaid resource use to address the question: Does providing Medicaid LTSS influence dually eligible Medicaid recipients’ use of Medicare resources and, if so, how and to what extent? Report results suggest two general aspects of these effects: (1) Medicaid LTSS provided in the community are associated with an increase in the number of Medicare services used with no, or limited, additional Medicare costs overall, and (2) Medicaid institutional supports offset Medicare resource use overall. The report also highlights analytic methods used, including propensity score matching techniques. The view the report, click here. To view the bulletin, click here.

Hilltop Executive Director Charles Milligan testified before the Maryland State Senate Finance Committee on February 2, 2010, regarding proposed legislation to require chronic care hospitals to develop a financial assistance policy for providing free and reduced–cost care, as well as to establish debt collection policies and procedures. This legislation was developed as a result of recommendations made by a work group convened by the Health Services Cost Review Commission (HSCRC) to review hospital financial assistance and debt collection policies and practices. Hilltop provided in-depth analyses of these policies and practices to inform the group’s work. Milligan testified on a panel with Robert Murray, executive director, and Steve Ports, principal deputy director, of HSCRC.

Posted 02/03/10

Bulletin: Hilltop Releases Issue Brief on Findings from New Mexico SCI Program Evaluation

To disseminate the findings of the first formal evaluation of New Mexico’s State Coverage Insurance (SCI) program, The Hilltop Institute at UMBC has just released a new issue brief entitled Small Business Participation in the New Mexico State Coverage Insurance Program: Evaluation Results. The purpose of the study was to identify factors that have influenced employer participation in SCI. The evaluation was partially funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) program through a partnership between the New Mexico Human Services Department (HSD) and The Hilltop Institute. Hilltop Senior Research Analyst Anna S. Sommers, PhD, was principal investigator for the project. To view the issue brief, click here. To view the bulletin, click here.

The Hilltop Institute has just released a new series of chart books, entitled MedicaidLong-Term Supports and Services in Maryland, that summarizes demographic, service utilization, and expenditure data for state fiscal years 2001 through 2008 on three Maryland Medicaid waiver programs—the Older Adults Waiver, the Living at Home Waiver, and the Autism Waiver—and on nursing facility utilization among Maryland Medicaid recipients. These chart books, prepared for the Maryland Department of Health and Mental Hygiene and now made available to the public online, are intended to monitor trends in these programs. Hilltop plans to update the chart books annually. To view the bulletin, click here.

Posted 01/19/10

Hilltop Presents to State Officials on Status of Federal Health Reform

Hilltop Executive Director Charles Milligan gave a webinar for state officials on January 15, 2010. In this webinar, sponsored by the Robert Wood Johnson Foundation State Coverage Initiatives (SCI) program administered by AcademyHealth, Milligan discussed the current status of national health reform and its potential impact on the states. Milligan provided participants with the most up-to-date information on where things stand in the process, including the major areas of House-Senate agreement, the minor and major areas of House-Senate disagreement, and key implications for states. To view the presentation, click here.

Posted 01/16/10

Hilltop Assists New Mexico in Obtaining Medicaid Waiver to Continue its SCI Program

The Hilltop Institute assisted the New Mexico Human Services Department with preparing the application to the Centers for Medicare and Medicaid Services (CMS) for a Section 1115 Medicaid Demonstration project entitled the New Mexico State Coverage Insurance (SCI) Demonstration. This demonstration will permit the state to continue coverage for non-pregnant childless adults aged 19 through 64, with incomes up to and including 200 percent of the federal poverty level (FPL). The program is designed to provide health care coverage to uninsured individuals who are unemployed, self-employed, or employed by a participating small business employer. The program was previously funded through a Section 1115 waiver under the Children’s Health Insurance Program (CHIP). When the program was reauthorized in 2009, a new waiver was necessary. Hilltop worked with New Mexico on the development of the waiver application, including performing the analysis to determine and establish budget neutrality.

Hilltop Presents to Maryland State Legislature

Hilltop Executive Director Charles Milligan participated on a panel that made a presentation before the Health and Government Operations Committee of the Maryland House of Delegates at a hearing on November 17, 2009, entitled Federal and State Trends in Hospital Oversight. The other presenters were Keith Hearle, President of Verité Healthcare Consulting, LLC, and Donna Folkemer, Group Director of the National Conference of State Legislatures. The presentation described national trends in tax-exempt hospital oversight; discussed state policy directionsin financial protections for hospital customers; andpresented two catalysts for state policymaking: insurance coverage rates and hospital behavior. Click hereto view the presentation.

Hilltop Director of Long-Term Supports and Services Cynthia Woodcock presented findings from a Hilltop study directed by Senior Research Analyst Harriet Komisar, PhD, of community-based services in 11 states at the Maryland Department of Health and Mental Hygiene (DHMH) Long-Term Care Payment Advisory Committee (LTC PAC) meeting on November 12, 2009. Entitled Medicaid Rate-Setting Methods for Community Services in Selected States, the presentation described the community service system in Maryland, discussed the study, and presented the findings. The study focused on rate-setting methods for personal care, adult day care, and assisted living. Click here to see Hilltop’s presentation.

Posted 11/13/09

Hilltop Presents at National APPAM Research Conference

Hilltop Research Analyst Laura Spicer presented the findings of Hilltop’s evaluation of the New Mexico State Coverage Insurance (SCI) program at the Association for Public Policy Analysis and Management (APPAM) 31st annual research conference,Evidence-Based Policy Making in the Post-Bush/Clinton Era, on November 7, 2009, in Washington, D.C. Entitled Evaluation of Small Group Employer Participation in New Mexico's State Coverage Insurance (SCI) Program, the presentation was part of a panel on state health policy. In the presentation, Spicer gave an overview of the SCI program; presented results of the Hilltop surveys of employers who participated as well as those who inquired about but did not participate in the program; discussed implications for states that want to engage small businesses to participate in state coverage initiatives; and discussed implications for federal reform. To view the presentation, click here. In addition, on November 5, 2009, Hilltop Executive Director Charles Milligan was a discussant on a panel entitled Working with States to Develop Health Care Reform Initiatives: Research, Analysis, Politics, which addressed various aspects of health care reform at the state level.

Posted 11/08/09

Hilltop Presents to Groups around the Country on Health Care Reform

This October, Hilltop Executive Director Charles Milligan has been making presentations to groups around the country on health care reform. On October 13, 2009, Milligan presented at an AcademyHealth-sponsored national teleconference. Over 100 lines called in, from Governor's offices, insurance departments, Medicaid and SCHIP agencies, and so on, representing over 40 states. On October 23, 2009, Milligan gave a presentation to the Louisiana Health Care Commission; on October 24, 2009, he gave a presentation to the National Association of Latino Elected and Appointed Officials (NALEO) Latino Legislative Summit on Health Disparities. In each presentation, Milligan described the health care reform process currently occurring in Congress, gave an update on the status of the Senate and House bills, and discussed two scenarios for how the process could conclude. For the Latino Legislative Summit, Milligan also discussed implications for states based on each scenario. To view the Summit presentation, which includes the implications for states, click here.

Posted 10/14/09

Hilltop Presents at NYIT Annual Aging and Society Conference

Hilltop Senior Research Analyst Harriet L. Komisar, Ph.D., gave a presentation at the New York Institute of Technology (NYIT) Center for Gerontology and Geriatrics Second Annual Conference on Aging and Society: “Reforming Long Term Care—Back to the Future” on October 7, 2009, in Westbury, New York. Komisar’s presentation, entitled You Can Run, But You Can’t Hide: Facing the Costs of Long-Term Care, provided an overview of long-term care (LTC), the population who utilizes it, and the common types of LTC assistance needed; discussed the costs of LTC from both an individual’s perspective and the national perspective; and made suggestions as to how the nation can prepare to meet the future needs of this increasing population. To view the presentation, click here.

Hilltop Executive Director Charles Milligan gave a presentation at the National Association for State Health Policy’s (NASHP’s) 22nd Annual State Health Policy Conference on October 6, 2009 in Long Beach, California. In the presentation, entitled Nonprofit Hospitals: Earning Their Tax-Exempt Status Tying Medicaid Coverage to Tax Exemption, Milligan gave a brief history of the relationship between tax-exempt status and insurance coverage; discussed trends in insurance coverage; and suggested potential roles for tax-exempt hospitals in financing public insurance. To view the presentation, click here.

Posted 10/07/09

Bulletin: Findings from Hilltop Study of Using Tax Forms to Identify Medicaid/CHIP-Eligible Children Released

The State Health Access Reform Evaluation (SHARE) has released an issue brief entitled, Using Information from Income Tax Forms to Target Medicaid and Chip Outreach: Preliminary Results of the Maryland Kids First Act. The brief discusses the preliminary results of Hilltop’s evaluation of the outreach effort of Maryland’s Kids First Act. The view the brief, click here. To view the bulletin, click here.

Posted 10/06/09

Findings from Hilltop Study of Using Tax Forms to Identify Medicaid/CHIP-Eligible Children Released

The State Health Access Reform Evaluation (SHARE) has just released an issue brief entitled Using Information from Income Tax Forms to Target Medicaid and Chip Outreach: Preliminary Results of the Maryland Kids First Act. The brief discusses the preliminary results of Hilltop’s evaluation of the outreach effort of Maryland’s Kids First Act. Maryland is one of the first states in the country to use information from state income tax forms to identify and enroll Medicaid and CHIP-eligible children. As a result of this innovative approach, SHARE commissioned the Maryland Department of Health and Mental Hygiene and its partner, The Hilltop Institute, to evaluate the outreach strategy. Hilltop Director of Medicaid Policy Studies David Idala, M. A., is principal investigator and research team leader. The brief identifies ten lessons learned from the experience so far, addressing issues such as data-sharing, health literacy, inclusion/exclusion criteria, tracking mechanisms, and the circumstances under which legislation is necessary in order to implement tax-based outreach. The project is funded by SHARE, a national program of the Robert Wood Johnson Foundation®, with direction by the State Health Access Data Assistance Center at the University of Minnesota School of Public Health. To view the brief, click here.

The Hilltop Institute assisted the New Mexico Human Services Department with preparing the renewal applications to the Centers for Medicare and Medicaid Services (CMS) for the Mi Via (My Way) self-directed waiver program. The program operates under two Section 1915(c) Medicaid waivers—one for individuals who might otherwise require care in a nursing home and the other for individuals with developmental disabilities. With Mi Via, participants can avoid institutionalization and remain at home or in the community. Participants manage their own budget and may choose from a wide array of home and community-based services, ranging from supports for community living to health and wellness supports. Hilltop worked with New Mexico on the initial design of Mi Via, originally launched in 2006. Mi Via is recognized as one of the most innovative Medicaid self-directed waiver programs in the country.

Hilltop Presents at NASHP Maximizing Enrollment for Kids Conference

Hilltop Executive Director Charles Milligan gave a panel presentation at the National Academy for State Health Policy’s Maximizing Enrollment for Kids Conference in Washington, D.C. on September 25, 2009. The panel, Streamlining Enrollment: One-Lane Highway to Express Lane, addressed the new CHIPRA Express Lane Eligibility option and early state experiences with automated enrollment strategies, including Maryland’s Kids First Initiative. Milligan’s presentation, entitled Maryland’s Kids First Act: Using Tax Forms to Identify Medicaid/SCHIP-Eligible Children, described the Act and its requirements; Maryland’s implementation; and the Hilltop evaluation of the outreach effort of using state income tax forms to identify and enroll uninsured but eligible children in Medicaid or CHIP. To view the presentation, click here.

Posted 09/26/09

Hilltop Presents at NASUA Membership Meeting

Hilltop Senior Research Analyst Ian Stockwell, M.A., gave a presentation entitled Data Integration in HCBS Program Development at the National Association of State Units on Aging 45th annual membership meeting in Denver, Colorado on September 23, 2009. The presentation discussed the potential that state policymakers now have to pull individual-level information together to form a complete picture of a program population through data integration. This method can provide a wealth of demographic and health status information for program building, as well as help predict service use, set appropriate individual budgets, and determine potential cost savings. Stockwell provided a brief overview of data sources currently available in most states; discussed the potential of new web-based information systems and provided a case study of a system currently in use; and discussed possible metrics and benchmarks, as well as some “best practices” on how to combine disparate datasets. To view the presentation, click here.

The Hilltop Institute has released a new report entitled, Examining Rate Setting for Medicaid Managed Long-Term Care. The report, authored by Anthony M. Tucker, PhD, and Karen E. Johnson, MS, is the second in a series that explores the cross-payer effects of providing Medicaid long-term supports and services on Medicare acute care resource use. Patterns of Medicaid eligibility, as well as resource use under both Medicare and Medicaid, are examined primarily within the context of service use-based groups that can be used to set rates for Medicaid capitation payments for managed long-term care. The view the report, click here. To view the bulletin, click here.

Posted 09/16/09

Bulletin: Hilltop Hosts Symposium on the Effectiveness of
Home and Community-Based Services

The Hilltop Institute is pleased to present the proceedings of the sixth Hilltop Symposium, Home and Community-Based Services (HCBS): Examining the Evidence Base for State Policymakers, convened on June 11, 2009, at UMBC. The Hilltop Symposium brought together more than 130 policymakers, health services researchers, and healthcare practitioners, including some of the nation’s leading HCBS researchers and policy experts, from across the country to discuss the measures and evidence to examine whether the expansion of home and community-based services has produced desired outcomes (quality, choice, cost, satisfaction, and safety) in the long term for older adults and persons with disabilities. The day was divided into four sessions and was highlighted by a keynote address, a luncheon address, and concluding reflections. To view the bulletin, click here.

Posted 07/11/09

Hilltop Disseminates Research Findings on New Mexico’s SCI Program across the Country

Hilltop researchers have been actively presenting the findings of their study of employer participation in New Mexico’s State Coverage Insurance (SCI) program. The study, funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) program, determined what factors influence small business employer participation or non-participation in SCI, one of the state’s efforts to expand health coverage to low-income New Mexicans who are not eligible for Medicaid. Anna Sommers, PhD, a Hilltop senior research analyst and the project’s principal investigator, released the study’s findings at the 2009 AcademyHealth Annual Research Meeting in Chicago, Illinois on June 27 and June 30. Sommers participated on two panels: Early Results from the State Health Access Reform (SHARE) Program, and The Lab Reports: Evaluating States’ Actions to Expand Access & Coverage. On July 6, in the Pueblo of Laguna, New Mexico, Charles Milligan, JD, MPH, Hilltop’s executive director and an investigator on the project, included study results in his testimony before the New Mexico Legislative Health and Human Services Committee about the new Children’s Health Insurance Program Reauthorization Act (CHIPRA) and its impact on the SCI program. Changes in what CHIP funds can be used for have the potential to reduce funding for SCI, and the state is exploring its options in regard to sustaining the program. Most recently, on July 31, at the State Coverage Initiatives Annual Meeting in Albuquerque, New Mexico, Asher Mikow, MHA, a Hilltop research analyst and investigator on the project, and Mari Spaulding-Bynon, JD, Insure New Mexico! Bureau Chief at the New Mexico Human Services Department and co-principal investigator of the project, presented research results in a session entitled Research & Evaluation of State Reforms. Dissemination activities are also occurring within New Mexico, including presentations to program stakeholders, and other interested parties. A number of issue briefs are expected to be published in the fall by both the Robert Wood Johnson Foundation’s SHARE program and The Hilltop Institute. View the AcademyHealth presentation. View the handouts.

Hilltop Executive Director Charles Milligan, JD, MPH, was the luncheon keynote speaker at the AcademyHealth State Coverage Initiatives Annual Meeting on July 30, 2009 in Albuquerque, New Mexico. In his speech on health reform, Milligan outlined the current efforts to pass federal health reform and its potential impact on states and analyzed the federal-state relationship in the context of comprehensive reform. In addition, Milligan participated on a panel entitled Medicaid and the Children's Health Insurance Program: The Case for Increased Outreach and Enrollment Efforts, which highlighted the enhanced importance of state efforts to enroll eligible populations in public coverage programs. The session focused on ways to increase enrollment, and the increased incentives for doing so under Children's Health Insurance Program Authorization Act (CHIPRA), through examples such as express lane eligibility, facilitated enrollment, intensive application assistance, automated eligibility, etc. The session also examined Maryland's lessons learned in creating a system to identify and enroll uninsured children via income tax forms. Milligan's presentation, entitled Maryland's Kids First Act: Using Tax Forms to Identify Medicaid/SCHIP-Eligible Children, described the Kids First Act, Maryland's implementation activities, and discussed the initial results of Hilltop's study of the effectiveness of the state's outreach efforts. The study was commissioned by the Robert Wood Johnson Foundation's State Health Access Reform Evaluation (SHARE) program. To view the presentation, click here.

As part of its role to provide consultation and technical assistance to the Maryland Department of Health and Mental Hygiene, Hilltop staff made two presentations before the Payment Advisory Committee Workgroup of the LTC Reform Committee on September 2, 2009. Charles J. Milligan, Jr., JD, Hilltop’s executive director, gave a presentation entitled, Nursing Facility Payment Policy: Comparing Maryland to Other States, in which he described findings from a Hilltop study that examined the Medicaid nursing facility (NF) payment systems of all 50 states and the District of Columbia, and then compared Maryland’s payment system to that in other states. To view this presentation, click here. Anthony M. Tucker, PhD, Hilltop’s director of special projects, gave a presentation entitled Resource Utilization Groups (RUGs), in which he described RUGs, the LTC minimum data set (MDS) as it is used to assign RUGs to NF residents, and Hilltop’s process to refine MDS data to examine patterns of care. Hilltop refined MDS data were also used to show the distribution of Maryland’s NF residents, as well as measures of length of NF stays, by RUG level and payor. To view this presentation and accompanying exhibits, click here.

Harriet Komisar Joins The Hilltop Institute

Harriet L. Komisar, PhD, a health economist with more than fifteen years of experience researching topics related to long-term care financing and health policy, has joined The Hilltop Institute as a senior research analyst in the Long-Term Supports and Services (LTSS) unit. In this capacity, she will assume a leadership role in developing and managing research and policy analysis related to LTSS for older adults and other persons with disabilities. Prior to joining Hilltop, Komisar was a research professor in the Health Policy Institute at Georgetown University. While at Georgetown, her research focused on assessing needs and access to long-term care for individuals eligible for both Medicare and Medicaid—dual eligibles—and developing and modeling alternatives for long-term care financing. Previously, Komisar was a principal analyst at the U.S. Congressional Budget Office, where she worked on issues related to Medicare's payment policies.

Hilltop Sponsors Symposium on the Effectiveness of Home and Community-Based Services

The Hilltop Institute sponsored the sixth Hilltop Symposium at which national experts discussed the measures and evidence to examine whether the expansion of home and community-based services (HCBS) has produced desired outcomes (quality, choice, cost, satisfaction, and safety) in the long term for older adults and persons with physical disabilities. The day was divided into four sessions and highlighted by a keynote address, a luncheon address, and concluding reflections. More than 130 policy makers, health services researchers, and health care practitioners from across the country, including the leading experts in the field, participated in the event. Click here to learn more.

Hilltop Partners with MIPAR to Win NIDRR Grant

The Hilltop Institute and its partner, the Maryland Institute for Policy Analysis and Research (MIPAR), at the University of Maryland, Baltimore County, have been awarded a National Institute on Disability and Rehabilitation Research (NIDRR) grant for a field-initiated project entitled Health Care Disparities in Access and Utilization among Individuals with Disabilities, scheduled to begin on October 1, 2009. The study will combine national survey data from the National Health Interview Survey (NHIS) and the Medical Expenditure Panel Survey (MEPS), pooling six years of data. Three measures of access and five measures of utilization will mirror those included in the series of Agency for Healthcare Research and Quality National Healthcare Disparities reports. The study’s analytic strategies will allow researchers to identify subpopulations with disabilities that are disparately impacted by system and individual characteristics, ‘doubly underserved’ individuals due to system-level and individual characteristics Researchers will identify factors which have the potential capacity to affect practice and policy, with the aim of elimination of disparities in health and function among individuals with disabilities. Annette Snyder, PhD, MSN, Hilltop’s director of clinical and quality management, is a co-investigator on the grant and will lead Hilltop’s project team. Adele Kirk, PhD, assistant professor of public policy, is also a co-investigator. Nancy Miller, PhD, associate professor of public policy, is the principal investigator and project leader.

Hilltop Presents on Evaluation of New Mexico's State Coverage Insurance Program at AcademyHealth Annual Research Meeting

Anna S. Sommers, PhD, a senior research analyst at The Hilltop Institute, participated on two panels at the AcademyHealth Annual Research meeting in Chicago, Illinois. The first panel occurred at the AcademyHealth State Health Research and Policy Interest Group Meeting, part of the pre-conference proceedings, on June 27 and was entitled Early Results from the State Health Access Reform (SHARE) Program. The second panel, entitled The Lab Reports: Evaluating States’ Actions to Expand Access & Coverage, occurred at the AcademyHealth Annual Research Meeting (ARM) on June 30. At both sessions, Sommers presented the findings from the Hilltop evaluation of small group employer participation in the New Mexico State Coverage Insurance (SCI) program. Sommers and her research team studied the factors that influence small employers’ decisions to participate in SCI, and found policy implications for both states and for federal reform. Policy implications for states are that there is a significant tradeoff between accessing federal dollars and employer recruitment; that some states use standards more transparent to employers; and that reaching the smallest firms may require different strategies. Implications for federal reform are that de-linking federal dollars from Medicaid/CHIP could allow use of more transparent and/or simplified eligibility standards; and that the pay-or-play federal mandate could assist states in engaging larger employers. The evaluation is partially funded by a grant from the Robert Wood Johnson Foundation State Health Access Reform (SHARE) Program. To view the presentation, Click here. To view the handout materials, Click here.

Posted 06/28/09

Hilltop to Collaborate with RWJF SHARE Program on Issue Brief on Use of Tax Forms to Identify Medicaid-Eligible Children

The Hilltop Institute’s Director of Medicaid Policy Studies David Idala made a panel presentation entitled Preliminary Findings of an Evaluation of the Maryland Kids First Act: The Use of Tax Forms to Identify Medicaid/SCHIP-Eligible Children at an AcademyHealth Special Interest Group (SIG) Meeting on June 27 in Chicago, Illinois. The presentation, part of the pre-conference proceedings of the AcademyHealth National Research Meeting, was based on an abstract that had been one of 33 high-quality abstracts submitted for peer review. Only two abstracts were chosen for this panel following the rigorous selection process. Idala is the principal investigator of a Robert Wood Johnson Foundation funded State Health Access Reform Evaluation (SHARE) project entitled Evaluating the Success of Maryland’s Kids First Act Outreach at Identifying and Enrolling Uninsured Eligible Children in Medicaid or SCHIP. As a result of the presentation, SHARE has invited Hilltop to collaborate on an issue brief regarding the preliminary findings of the study. To view the presentation, click here.

Posted 06/28/09

Hilltop Presents at Center for Health Care Strategies Meeting

Anthony M. Tucker, Ph.D., Director of Special Projects at The Hilltop Institute, gave a presentation at the kick-off meeting for the Transforming Care for Dual Eligibles initiative on June 17, 2009. This initiative, sponsored by the Center for Health Care Strategies, Inc. and funded by The Commonwealth Fund, will test innovative care models in eight states for people who are dually eligible for Medicare and Medicaid. In the session, entitled Medicare and Medicaid Data Analysis/Integration, Dr. Tucker focused on the integration and analysis of Medicare and Medicaid data; discussed his development and use of The Hilltop Crossover Framework-a new tool for the analysis of integrated care for dual eligibles; and discussed preliminary findings of his Robert Wood Johnson funded HCFO study of cross-payer effects for dual eligibles. To view the presentation, click here.

Posted 06/18/09

Hilltop Presents on Consumer-Directed Long-Term Care

Hilltop Executive Director Charles Milligan made a presentation before the District of Columbia (DC) Department of Health Care Finance on March 31, 2009. The presentation was part of the department’s Innovation in Health Policy Series. In the presentation, entitled Putting the Consumer First: Consumer Direction in Long-Term Care, Milligan painted a portrait of long-term care; discussed the aspects of consumer direction, showing examples from New Mexico’s Mi Via program, which Hilltop helped develop; and discussed the functions and competencies that are necessary to develop and implement a successful consumer-directed long-term care program. To view the presentation, click here.

Hilltop Presents at Medicaid Managed Care Summit

The Hilltop Institute’s executive director, Charles Milligan, made a presentation at the 2nd Annual Medicaid Managed Care Summit on February 25, 2009. The presentation, entitled New Mexico’s Coordinated Long-Term Services (CoLTS) Program, was part of a track concerning SNPs (Special Needs Plans) and Integrating Medicaid and Medicare. Milligan painted a portrait of dual eligibles (persons dually eligible for Medicare and Medicaid), painted a portrait of long-term care, and discussed New Mexico’s approach to coordinate services for this population, their CoLTS program. This program, which Hilltop helped New Mexico develop, seeks to: promote community-based services (CBS) by diverting or shortening nursing home stays; promote flexible benefit design to achieve new CBS models; improve quality through coordination of Medicare and Medicaid; and achieve financial savings by aligning Medicare and Medicaid incentives. To view the presentation, click here.

The Hilltop Institute and its subcontractor, Verité Healthcare Consulting, LLC, synthesized and analyzed the financial assistance and credit and collection policies of all 47 of Maryland’s hospitals to assist the Maryland Health Services Cost Review Commission (HSCRC) in their response to Governor O’Malley’s request that the HSCRC perform a thorough review of hospital debt collection practices. The purpose of the analysis was to determine: if a general consensus exists among Maryland’s hospitals on various key aspects of the policies; if the financial assistance policies comply with the voluntary guidelines established by the Maryland Hospital Association (MHA) as a minimum expectation for hospitals; and if such policies in Maryland are in accord with national trends and perspectives. Hilltop’s findings were incorporated in the HSCRC report, which was released on February 13, 2009.

Cynthia Boddie-Willis Joins The Hilltop Institute

The Hilltop Institute is pleased to announce the addition of Cynthia Boddie-Willis, MD, MPH, as director of the newly reorganized Acute Care Policy and Research Unit. In this position, she will manage Hilltop’s initiatives in acute care policy, clinical and quality management, and research. Under her direction, Hilltop will continue to provide assistance to MCOs, state health agencies, local health departments, and other health care organizations in implementing Medicaid managed care programs; monitoring MCO performance; analyzing service utilization; identifying access barriers; evaluating the quality, affordability, and sustainability of publicly funded healthcare services; analyzing the administrative efficiency for health programs and systems; and informing health policy development. Her main research interest is in health disparities, a prominent theme of Hilltop’s work. Dr. Boddie-Willis was formerly Director of the Division of Health Promotion and Disease Prevention at the Massachusetts Department of Public Health, where she had oversight of the program development, implementation, and evaluation of health communications, health and the built environment, nutrition, physical activity, chronic disease prevention and management, healthy aging, health and disability, women’s health, and men’s health. In addition, she was a practicing physician at a federally qualified community health center, and hopes to continue to practice in Maryland. She comes to Hilltop with over 30 years of experience addressing the health care needs of vulnerable populations.

The Hilltop Institute’s executive director, Charles Milligan, made a presentation to Michigan policymakers at an informational forum on December 11, 2008. In the presentation, entitled Integrated Managed Long-Term Care, Milligan gave a description of dual eligibles (persons eligible to receive both Medicare and Medicaid) and of long-term care; discussed various approaches to managed long-term care; described New Mexico’s approach, including their Coordination of Long-Term Services (COLTS) program, which Hilltop helped develop; and discussed Michigan’s challenges and opportunities for developing integrated managed long-term care. To view the presentation, click here.

Posted 12/12/08

Hilltop to Collaborate with Maryland on State Health Access Reform Evaluation

The Hilltop Institute and the Maryland Department of Health and Mental Hygiene (DHMH) have been commissioned by the Robert Wood Johnson Foundation State Health Access Reform Evaluation (SHARE) Initiative to perform an evaluation of the Kids First Act. The Kids First Act is the first law in any state to utilize the income and household information reported on state income tax returns to target outreach efforts to children who may be eligible for Medicaid or SCHIP. This is SHARE’s first commission. Hilltop will perform the study, which will evaluate the success of the act’s outreach efforts. Study results should not only help Maryland reduce the number of uninsured children in the state, but also help inform policymakers in other states. Senior Research Analyst Cheryl Powell, MPP, at The Hilltop Institute, is the principal investigator for the project. She will lead Hilltop’s project team, which includes Senior Research Analyst Anna Sommers, PhD, and Urban Institute Consultant Stan Dorn, JD. DHMH Office of Eligibility Services Director Cheryl Camillo, MPA, is co-principal investigator.

Cheryl Powell, senior research analyst at The Hilltop Institute, gave a presentation for the Transportation Association of Maryland’s 20th Annual Fall Conference, Reaching, Teaching, and Serving…Our 20 Year Journey, on October 20 and 21. In the presentation, entitled Maryland Medicaid Non-Emergency Medical Transportation Study, Powell described the study—which evaluated the feasibility of creating a uniform statewide NEMT program in Maryland; any potential cost savings or potential for quality improvement; and the potential impact of the creation of such a program on local health departments—and discussed its findings. Hilltop conducted the study, which was mandated by House Bill 235, on behalf of the Maryland Department of Health and Mental Hygiene. To view the presentation, click here.

Posted 10/12/08

Hilltop Wins Contract to Map Rhode Island’s Long-Term Care Resources

The Hilltop Institute has won a contract from the New England States Consortium Systems Organization for Real Choices Long-Term Care Resource Mapping in the state of Rhode Island. Hilltop’s work will inform the state’s policy making by providing comprehensive information on Rhode Island’s current and projected population requiring publicly-financed long-term supports and services, the state’s institutional capacity, and the availability of community supports and services across the state. The project will also produce a tool for modeling the effects of various options for rebalancing state spending between institutional and home- and community-based services.

Hilltop Presents at National Home- and Community-Based Services Conference

The Hilltop Institute’s Director of Long-Term Supports and Services, Cynthia H. Woodcock, and Manager of Health Services Research, Al Adamson, presented a workshop on September 29, 2008, in Boston, at The Spirit of Independence: 24th National Home and Community Based Services Conference, convened by the National Association of State Units on Aging. In the workshop, entitled A Methodology for Projecting a State's Long-Term Care Costs, they discussed the methodology that Hilltop developed to project long-term care costs in Maryland for 2010, 2020, and 2030; discussed how other states could use that methodology to project future spending; and offered guidelines on how states could facilitate change in their long-term care systems. To view the presentation, click here. To view the full report, click here.

Posted 09/30/08

Hilltop Participates in Heritage Foundation Forum

The Hilltop Institute’s executive director, Charles Milligan, was an expert witness in an invitational forum hosted by The Heritage Foundation, on September 24, 2008, that explored innovative models for states’ reform of Medicaid programs and other vehicles for long-term care, paying particular attention to the concerns of the elderly and disabled. Entitled Workable Solutions for Long-Term Care, the forum simulated a Congressional hearing, in which health policy experts presented testimony and then fielded questions from a panel of distinguished members. Milligan presented in the session entitled Private Sector Models in the Context of Medicaid Reform, and focused on emerging opportunities to align Medicare and Medicaid payments and incentives. The goal of this alignment would be to reform Medicaid (and Medicare) to facilitate: the improvement of hospital discharge planning in a way that might avoid or reduce Medicaid-paid nursing facility stays; the improvement of the quality of long-term care services in a way that might avoid unnecessary Medicare-paid hospital admissions and emergency room use; and the promotion of greater flexibility in benefit delivery. To view Milligan’s testimony, click here.

Posted 09/25/08

Bulletin: Hilltop Releases Resource Guide to Explore Relationships
between Medicare and Medicaid Service Use and Costs

The Hilltop Institute has just released A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data as a resource guide for analysts who plan to integrate data on Medicare and Medicaid service use and costs. The Hilltop Crossover Framework is introduced in the guide as an orienting reference device for linked Medicare and Medicaid claims, and is based on a two-by-two format whereby data are arrayed by category of service-with specific reference to Medicaid crossover claims-in order to highlight the relationships between government programs and service use. The term "crossover" refers to Medicaid claims that reflect Medicare patient liability costs that state Medicaid programs cover on behalf of persons eligible under both programs-"dual eligibles" or "duals," for short. The guide is also intended as a general introduction to Medicare and Medicaid benefits and attendant relationships for analysts who may be less familiar with one or both programs. To view the bulletin, click here.

Posted 09/05/08

Hilltop Collaborates with New Mexico in Development of New Coordinated Long-Term Services Program

The Hilltop Institute collaborated with the New Mexico Human Services Department in the development of a new coordinated long-term services program that has just received federal approval. The program will serve an estimated 38,000 Medicaid beneficiaries statewide, the vast majority of whom are enrolled in both Medicare and Medicaid ("dual eligibles"). The enrollees who are not dual eligibles will meet a nursing facility level of care even though many are already served in the community. Known as the Coordination of Long-Term Services (COLTS) Program, New Mexico's model will operate under a Section 1915(b)(c) waiver from the Centers for Medicare and Medicaid Services (CMS), and the state will contract with two managed care organizations (MCOs) that are also Medicare Advantage Special Needs Plans. The state has two major goals in COLTS: to coordinate Medicare and Medicaid services by contracting with MCOs that may serve the beneficiaries in both programs, and to coordinate the full array of Medicaid services in order to promote community-based services where appropriate for the given beneficiary. The program will be implemented on a statewide basis over the next 11 months. Hilltop has been working with New Mexico over the past three years to design the program, develop the waivers, and advise the state on the capitated rate structure.

Hilltop Presents at Colorado’s Centennial Care Choices Program Panel

The Hilltop Institute’s executive director, Chuck Milligan, gave a presentation on benefit design on August 4, 2008, before the Colorado Centennial Care Choices Program Panel, a governor-appointed expert panel charged with gathering information on the design, benefits, and costs of a Value Benefit Plan for the people of Colorado. Milligan discussed the concept of minimum benefits (a state’s determination of what constitutes “being insured”) and policy implications, such as the balance between a given state’s determination of where to strike a balance between its role to protect its citizens, and its role to respect individual liberty/autonomy to purchase services in the market; the balance between coverage by private insurance and government programs that wrap around those benefits; and the balance between covering more people with leaner benefits, or fewer people with more comprehensive benefits. Milligan then presented alternatives utilized by different states to provide benefits to their uninsured citizens.

Posted 08/05/08

Bulletin: Center to Change its Name

The Center for Health Program Development and Management, located on Hilltop Circle at the University of Maryland, Baltimore County (UMBC), was established in 1994 in partnership with the Maryland Medicaid program. The name we chose for ourselves in 1994 reflected the activities that we performed for the Maryland Medicaid agency at that time: developing and managing selected health programs on their behalf. Our work for Maryland Medicaid continues to be fruitful, productive, and mutually beneficial. Over time, our work evolved. We now perform a much wider variety of health services research activities for Maryland Medicaid, as well as for a broad national collection of governmental and non-profit clients. The organizing mission of our work is to utilize analysis to advance the health of vulnerable populations. To view the bulletin, click here.

Posted 07/01/08

Bulletin: Hilltop Hosts Symposium on Oral Health Policy

The Hilltop Institute is pleased to announce the success of its fifth symposium, Developing Comprehensive Oral Health Policy: Challenges and Opportunities for State Health Policy Makers, convened on June 17, 2008. The symposium brought together over 130 policy makers, health services researchers, and health care practitioners, including the nation's leading oral health policy experts, from across the country to explore three major areas of policy innovation to improve access to and utilization of oral health care: integration of dental and medical service delivery; dental workforce issues; and health education and outreach strategies. The day was divided into four sessions and highlighted by a keynote address, a luncheon address, and concluding reflections. To view the bulletin, click here.

Posted 06/18/08

Hilltop Hosts Fifth Symposium on Health Policy

The Hilltop Institute sponsored a day-long symposium to explore three major areas of policy innovation to improve access to and utilization of oral health care: integration of dental and medical service delivery; dental workforce issues; and health education and outreach strategies. The day was divided into four sessions and highlighted by a keynote address, a luncheon address, and concluding reflections. Over 130 policy makers, health services researchers, and health care practitioners from across the country, including the leading experts in the field, participated in the event. Click here to learn more.

Posted 06/18/08

Hilltop to Collaborate with New Mexico on State Health Reform Evaluation

The Hilltop Institute, in collaboration with the New Mexico Human Services Department, has received a grant to perform an evaluation of the New Mexico State Coverage Insurance program (SCI). The grant is one of 15 nationwide that was awarded through the Robert Wood Johnson Foundation State Health Access Reform Evaluation (SHARE) Initiative. The project will identify factors that have influenced employer participation in the New Mexico SCI program through surveys and analysis of administrative data. The project will not only benefit New Mexico, but will have national significance as well. Other states may face similar operational challenges related to combining public health insurance coverage with commercial-style insurance that requires employer contribution. New Mexico’s experience with its SCI program will provide lessons to other states that implement public/private partnerships or premium assistance programs requiring employer cooperation. This project is a state/university research partnership between New Mexico and Hilltop. Senior Research Analyst Anna Sommers, PhD, at The Hilltop Institute, is the principal investigator for the project. She will lead Hilltop’s project team, which includes Acute Care Policy Director Ann Volpel, MPA, Research Analyst Asher Mikow, MHA, Economic Analysis Director Hamid Fakhraei, PhD, and Research Assistant Laura Spicer. Insure New Mexico! Director Mari Spaulding-Bynon, JD, is co-principal investigator.

Cynthia H. Woodcock, M. B. A., has been named director of Hilltop’s Long-Term Supports and Services Unit. In this capacity, she will manage Hilltop's initiatives in long-term care policy and lead Hilltop's work on the development of home- and community-based services waiver programs and other integrated long-term care initiatives. In addition, she will continue to manage Hilltop's contract with the New Mexico Human Services Department, which has focused on launching a new self-directed waiver program and a Medicaid managed long-term care initiative. Under her direction, Hilltop is also assisting with implementation of Maryland's Money Follows the Person demonstration and carrying out an evaluation of New Jersey's federal Systems Transformation Grant in long-term care. She succeeds Wayne Smith, who retired last month, and has been with the unit since 2007. Woodcock joined Hilltop in 2004 as a senior research analyst, working with Hilltop's executive director on strategic planning and new business development.

Hilltop Receives Grant to Study the Economics of Antipsychotic Drug Use in Maryland’s Medicaid Population

The Hilltop Institute, in partnership with the UMBC Department of Public Policy, has received a two-year grant from NIH to study the economics of antipsychotic drug use in Maryland’s Medicaid population. The principal aim of the study is to analyze Maryland’s Medicaid data to identify cost and clinical correlates to specific antipsychotic drug choices of patients with schizophrenia. The analysis will review data spanning the period from 2002-2005, and earlier as feasible for select subpopulations. Dr. Tony Tucker from Hilltop will assist the project by merging Medicare and Medicaid records in order to assess clinical heterogeneity and costs, specifically for persons receiving benefits from both programs (dual eligibles). Senior Research Analyst Michael Abrams, MPH, the project’s co-investigator, will lead Hilltop’s team. Dr. David Salkever, Professor, Department of Public Policy, is the project’s principal investigator.

Hilltop Issues First Bulletin

The Hilltop Institute has issued its first electronic Bulletin about a report it prepared for the Maryland Community Health Resources Commission on School Based Health Centers. The Bulletin is the first formal venue that Hilltop has had for news releases. It will be used to periodically disseminate information about important news from Hilltop and about reports it produces. The Bulletin is sent electronically to the health services community. To view the Bulletin, click here.

Center Presents at NGA Center for Best Practices Workshop

The Center’s Executive Director, Chuck Milligan, participated in a panel discussion entitled How To Determine the Minimum Set of Required Benefits at a workshop conducted by the National Governors Association (NGA) Center for Best Practices on March 27, 2008. The workshop, Defining Benefit Packages in Health and Medicaid Reform, addressed how states could define and develop benefit packages which address the unique needs of their Medicaid beneficiaries. Milligan’s presentation discussed how different policy approaches affect a state’s determination of the minimum set of benefits that it mandates, as well as cost implications for the state and for the beneficiaries. To view the presentation, click here.

Posted 03/28/08

Center to Collaborate on Study of Payment for Psychiatric Services

The Center is collaborating with the Bloomberg School of Public Health at Johns Hopkins University and the UMBC Public Policy Department on an NIMH funded project to study the cost and quality implications of payment for psychiatric services. Diagnosis Related Groups (DRGs) are commonly used to pay inpatient hospitals. However, most of inpatient psychiatric care is paid per diem. The research seeks to improve psychiatric DRGs, with billing and supplemental information from medical records, so that they can be used for payment purposes. The study will also provide insight into hospital quality performance under per case payment. Dr. Hamid Fakhraei is leading the Center's research team.

Center Presents at State Coverage Initiatives National Meeting

The Center's Executive Director Chuck Milligan and Director of Acute Care Policy Ann Volpel participated in separate panel discussions at the National Meeting for State Coverage Initiatives that was held February 6-8, 2008 in Nashville, Tennessee. Milligan participated on a panel addressing emerging issues in the Medicaid and SCHIP programs and gave a presentation on recent directions in broad national policy, their implications for states, trends in state activities, and reforms approved by CMS under the Deficit Reduction Act and Section 1115 Waiver programs. Volpel participated on a panel discussing how states have attempted to address access and affordability in the small group market and gave a presentation on the two reports the Center completed on marketing state coverage programs. To view the reports, click here.

In a new report prepared for the Maryland Community Health Resources Commission, the Hilltop Institute presents a financial portrait of Maryland's school-based health centers, identifies barriers to reimbursement, and makes policy recommendations to expand access to school-based health centers, further develop the infrastructure and stabilize the financing of centers, and promote increased reimbursement. Report findings served as the basis for a Call for Proposals issued by the Commission in December 2007. To view the bulletin, click here.

Posted 02/05/08

Center Presents Benefits of Coverage for Children to Idaho Legislative Committee

The Center's Executive Director, Chuck Milligan, presented information on the benefits of pursuing health insurance coverage for children and adolescents in Idaho on January 9 at the Cover Idaho Kids Coalition Meeting and Research Discussion. Funded by the Robert Wood Johnson State Coverage Initiatives program administered by AcademyHealth, these presentations gave an overview of research and literature that shows the positive relationship between health insurance coverage and good health outcomes. Milligan discussed the benefits of coverage to the child, the family, the community, and the system: that insurance coverage allows children and their families to access health care earlier, which can prevent more serious health problems and illnesses, thereby avoiding the need to use more expensive services, such as emergency rooms. Laura Spicer, a research assistant at the Center, reviewed the literature for the presentations.

The Center, in partnership with the MD Department of Health and Mental Hygiene (DHMH), has received funding from the Robert Wood Johnson Foundation Changes in Health Care Financing and Organization (HCFO) program to conduct a two-year study on the interactive effects of Medicare- and Medicaid-provided services, particularly with respect to rate-setting for coordinated/integrated programs of care for those who are enrolled under both programs (duals). The Center’s Tony Tucker headed up the development of the grant application and will serve as a co-principal investigator. Judy Kasper of Johns Hopkins University will also serve as a co-investigator. Tricia Roddy at DHMH will serve as the formal project director, which will ensure that the grant funds will generate matching federal funds to conduct the study.

The Center conducted a study to determine if the expansion of buprenorphine as a strategy for battling opioid addiction is cost-effective. Commissioned by the Baltimore City Health Department and funded by the Annie E. Casey Foundation, the study used Medicaid data to examine health care service utilization differences between opioid addicts who were treated for their addiction versus those who went untreated, reviewed the literature, and estimated clinical and financial benefits and costs. The study's results supported the value and effectiveness of opioid maintenance therapy (OMT), and suggested that expanding treatment access has the potential to reduce both individual suffering and the overall societal burden associated with opioid dependence without increasing the cost of medical care. The research also indicated that expanding OMT has the potential to save the publicly financed health care system money by reducing heroin-associated morbidity in Medicaid and other insured and uninsured populations. Researchers estimated the cost savings and found that Baltimore City could save over $4,000,000.00 per year if utilization of OMT were expanded. To view the study's five reports, click here.

Chuck Milligan gave a brief presentation on October 18 at the Center for Medicare Advocacy's conference, Medicare Advantage Special Needs Plans: A Beneficiary Perspective. The conference brought together beneficiary advocates, health policy advocates, researchers, SNP providers, Centers for Medicare and Medicaid Services (CMS) officials, and Congressional staff. The conference proceedings were anchored by three background papers, two of which were written by Chuck Milligan and Cynthia Woodcock. Invitees discussed and framed a set of recommendations to present to Congress and CMS. To view Chuck's presentation on connecting SNPs with state Medicaid programs, click here. To view the conference details and other materials, click here.

Posted 10/19/07

Center Disseminates Summary on Mental Health Symposium

The Center has produced a summary for the mental health symposium it hosted on June 12. This piece highlights the day's proceedings, including a summary of each speaker's presentation and overarching themes. Click here to read more on the events of Moving Forward: Designing and Financing Mental Health Services in an Era of Transformation.

Posted 06/13/07

Center Hosts Symposium on Mental Health Services

On June 12, 2007, the Center for Health Program Development and Management sponsored a symposium examining the evolving mental health system, how efforts to diffuse evidence-based practices and better coordinate services across agencies and branches of medicine are paying off, and the extent to which Medicaid managed care and other newer programming and financing strategies are helping transform the system. Click here for the program and presentations.

Posted 06/13/07

Center Co-Hosts Forum on Emergency Department Use

On June 7, 2007, the Center for Health Program Development and Management, together with the UMBC Department of Public Policy, sponsored a public policy forum examining emergency room services in Maryland. Click here for the program and presentations.

Posted 06/08/07

Ann Volpel to Direct Acute Care Policy Unit

Effective immediately, Ann Volpel has been selected to direct the Center's Acute Care Policy Unit. Ms. Volpel, who joined the Center as a research analyst in 2001, will now be responsible for directing the Center's work on Medicaid managed care policy, financing, and performance assessment, working with Maryland and other states. She will also manage the Center's work related to behavioral health and state coverage initiatives. She succeeds John O'Brien, who left the Center in January to join the Maryland Health Services Cost Review Commission.

Posted 03/22/07

Medicaid Commission Recommendations

The Center for Health Program Development and Management has been providing strategic and analytical support to the federal Medicaid Commission and assisting with preparation of the Commission's final report. On November 16, 2006, in Washington, Chuck Milligan, the Center's executive director, delivered this presentation as part of the discussion of the Commission's final report and recommendations:

Todd Eberly Receives Dissertation Award

Todd Eberly, a senior research analyst at the Center, has received the 2006 Annual Dissertation Award from the National Association of Schools of Public Affairs and Administration (NASPAA) for his dissertation entitled, Managing the Gap: Evaluating the Impact of Medicaid Managed Care on Service Use and Disparities in Health Care Access. Dr. Eberly examined whether racial and ethnic minorities experience disparate access to preventive health services in Maryland Medicaid and whether Maryland 's transition to Medicaid managed care had an impact on disparities. He received a Ph.D. in Public Policy from UMBC this past spring.

Medicaid Commission Presentations

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered these presentations to the federal Medicaid Commission in Washington, D.C., on September 6, 2006:

CPS Medicaid Undercount Update, August 31, 2006

A survey of Maryland Medicaid beneficiaries conducted by the Center in 2005 found a significant discrepancy in Medicaid enrollment between state records and the Current Population Survey (CPS) administered by the U.S. Census Bureau. To address the CPS undercount, the Center recommended that the Census Bureau alter the 2005 CPS survey instrument to include "Medical Assistance" as an alternative name for the Maryland Medicaid program. This is the name by which Medicaid is known to most Maryland Medicaid enrollees. The 2005 CPS, released August 29, 2006, reports a 15 percent increase in Maryland Medicaid enrollees, along with a slight decline in the number of uninsured Marylanders. While the CPS still reports a significant undercount in Maryland Medicaid enrollees, the undercount is now in the range of the national average (20%-25%). The increase in the number of Medicaid enrollees and the decrease in the number of uninsured are in line with estimates presented in the Center's report.

Health Insurance Symposium on June 13, 2006

The Center for Health Program Development and Management will host a one-day symposium on June 13, 2006, entitled The Changing Health Insurance Market: Implications for Public Policy and for State Government Purchasers. Click here for more information or contact Joyce Meyers at 410.455.6377 or jmeyers@hilltop.umbc.edu.

Posted 06/01/06

Medicaid Commission Presentation

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered this presentation to the federal Medicaid Commission in Dallas on May 17, 2006: Who Are the Dual Eligibles?

Axford Forum Coming to UMBC

On January 18, 2006, the Center will convene Ian Axford fellows and invited guests at UMBC for a one-day forum. Established in 1995, the Ian Axford Fellowships in Public Policy give outstanding American professionals opportunities to study, travel, and gain practical experience in public policy in New Zealand . Health care, the environment, taxes, ethnic diversity, and education are but a few of the topics that Axford fellows have investigated. The program has provided a unique opportunity to American policy professionals to engage in innovative thinking and explore diverse policy perspectives on a wide variety of topics.

This will be the first time that Axford fellows have come together. The agenda for the forum features presentations by the three 2005 Axford fellows who have recently returned to the United States.

Dena Ringold of the World Bank examined how programs might be tailored to better address the range of disparities faced by indigenous peoples and other vulnerable populations, such as the 15 percent of New Zealanders who are also Maori.

Nick Johnson of the Center on Budget and Policy Priorities studied New Zealand 's Working for Families program. He explored the relationship between fiscal and tax policy in meeting the needs of low-income populations while promoting efficient labor markets.

John O'Brien of the Center for Health Program Development and Management at UMBC investigated the complexities of measuring and rewarding performance in health care delivery systems.

Former Axford fellows will serve as responders, and the program will be placed in context with remarks by Robert Reischauer , President of The Urban Institute and former chair of the Ian Axford Fellowships selection committee; John Wood , New Zealand Ambassador to the United States; Annette Dixon , the World Bank's Director of Strategy and Operations for Europe and Central Asia Region; and Peter Watson , CEO of the Dwight Group and current chair of the Axford selection committee. Discussion among forum participants is expected to generate fresh insights and novel approaches to public policy that otherwise might not be considered.

Posted 01/01/06

Medicaid Commission Presentations

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered these presentations to the federal Medicaid Commission at its meeting in Washington on October 26-27, 2005:

New Issue Brief Coming Fall 2005

Academy Health has commissioned an issue brief entitled "Turning Medicaid Beneficiaries into Purchasers of Health Care: Critical Success Factors for Medicaid Consumer-Directed Health Purchasing." It will examine factors states should consider when launching Medicaid reforms such as those proposed in Florida, South Carolina, and West Virginia. The Center is collaborating with Academy Health's State Coverage Initiatives, a program of The Robert Wood Johnson Foundation, to prepare the issue brief.

Chuck Milligan Presents to Medicaid Commission

On August 17, 2005, Chuck Milligan , executive director of the Center for Health Program Development and Management, delivered a presentation to the Medicaid Commission. This presentation provided background information on the requirements and restrictions in the Medicaid program, and it touched on where flexibility does and does not presently exist.

Chuck Milligan Testifies to Senate Finance Committee

On June 28, 2005, Chuck Milligan, executive director of the Center for Health Program Development and Management, testified to the Senate Finance Committee at the invitation of Senator Charles Grassley, committee chairman. Mr. Milligan discussed state Medicaid financing arrangements, such as intergovernmental transfer (IGT) and upper payment limit (UPL) arrangements that involve public hospitals and nursing facilities, as well as Medicaid school-based reimbursement. Click here for Mr. Milligan's written testimony and here for his oral testimony.

In a Medicaid study required by Michigan's legislature, the Center evaluated whether capitated managed care involving multiple managed care organizations (MCO) is cost effective, when compared to three alternative delivery systems: fee-for-service, primary care case management, and a capitated managed care program involving a single statewide MCO. The Center's analysis concluded that the state of Michigan would save between $28 million and $129 million in state funds in FY 2006 when the current capitated program involving multiple MCOs is compared to all of the alternative delivery systems. The exact amount of savings that Michigan will achieve depends on the size of the managed care rate increase in FY 2006, and on which alternative delivery system is under consideration.

Impact of the Medicare Prescription Drug Benefit on Home- and Community- Based Services Waiver Programs

Home- and community-based services waiver programs enable many individuals dually eligible for Medicare and Medicaid to avoid nursing homes. But access to prescription drugs may be impeded when drug coverage is transferred from Medicaid to Medicare in January 2006, threatening the ability of dual eligibles to remain in the community. The Center examined the likely impact of the new Medicare drug benefit in Maryland and recommends federal policy remedies.

As Medicaid managed care programs mature, states are looking to refine their methods for measuring and improving the performance of participating health plans. This report serves as a guide for Medicaid agencies who want to develop a performance measurement program using administrative data to evaluate the care provided to enrollees with chronic diseases. The report identifies potential performance indicators that are associated with improved medical outcomes and demonstrates the application of diagnosis-based risk adjustment to performance measurement by profiling six health plans.

The Center for Health Program Development and Management Partners with the State of New Mexico

The Center is pleased to announce a new partnership with the New Mexico Human Services Department and New Mexico State University. The Center will assist New Mexico in developing and evaluating new Medicaid policies and programs. Initial work will focus on consumer-directed services and managed long-term care.